Cardiogenic Shock Secondary to Takotsubo Cardiomyopathy in a Patient with Preexisting Hypertrophic Obstructive Cardiomyopathy

[Display omitted] •Echocardiography is used to diagnose hypertrophic obstructive cardiomyopathy (HOCM) and Takotsubo cardiomyopathy (TCM).•Hypotension in a patient with TCM should be evaluated for left ventricular outflow tract obstruction (LVOTO).•Management of TCM is challenging in patients with HOCM with severe LVOTO.•Hypotension in LVOTO may paradoxically worsen with standard intravenous inotropes.•Fluid resuscitation, beta-blockers, alpha agonists, and intra-aortic balloon pump are the treatment options in LVOTO.