open access

Vol 15, No 6 (2020)
Case report
Published online: 2020-12-30
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‘A blessing in disguise’: the severe course of perioperative takotsubo syndrome associated with favorable long-term outcome.

Konrad Stępień, Karol Nowak, Paweł Rostoff, Barbara Szlósarczyk, Adam Stępień, Jadwiga Nessler, Jarosław Zalewski
DOI: 10.5603/FC.2020.0061
·
Folia Cardiologica 2020;15(6):419-422.

open access

Vol 15, No 6 (2020)
Case Reports
Published online: 2020-12-30

Abstract

In the current article, the case report of perioperative takotsubo syndrome in a 59-year-old woman with hypertension, paroxysmal atrial fibrillation and toxic nodular goitre was presented. During the induction of general anaesthesia before scheduled thyroidectomy, the cardiac arrest in the mechanism of asystole was diagnosed. As a result of cardiopulmonary resuscitation, the spontaneous circulation returned. The cardiogenic shock requiring catecholamines administration was noted. In the urgent coronarography, the marked slow flow phenomenon was observed in coronary arteries. The bedside echocardiogram revealed left ventricular ejection fraction (LVEF) deterioration to 20% with the akinesia of apical segments. The diagnosis of takotsubo syndrome was made. In the control examinations, the rapid clinical improvement with the increase of LVEF to 40% on the second day of hospitalization was observed. Due to the good general condition, the patient was discharged on the tenth day of hospitalization. Currently, the patient remains in cardiological out-patient care without any signs of takotsubo syndrome relapse. After 3.5 years of observation, the LVEF equalled 60% without significant disturbances in regional contractility.

Abstract

In the current article, the case report of perioperative takotsubo syndrome in a 59-year-old woman with hypertension, paroxysmal atrial fibrillation and toxic nodular goitre was presented. During the induction of general anaesthesia before scheduled thyroidectomy, the cardiac arrest in the mechanism of asystole was diagnosed. As a result of cardiopulmonary resuscitation, the spontaneous circulation returned. The cardiogenic shock requiring catecholamines administration was noted. In the urgent coronarography, the marked slow flow phenomenon was observed in coronary arteries. The bedside echocardiogram revealed left ventricular ejection fraction (LVEF) deterioration to 20% with the akinesia of apical segments. The diagnosis of takotsubo syndrome was made. In the control examinations, the rapid clinical improvement with the increase of LVEF to 40% on the second day of hospitalization was observed. Due to the good general condition, the patient was discharged on the tenth day of hospitalization. Currently, the patient remains in cardiological out-patient care without any signs of takotsubo syndrome relapse. After 3.5 years of observation, the LVEF equalled 60% without significant disturbances in regional contractility.
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Keywords

takotsubo syndrome, thyroidectomy, cardiac arrest, cardiogenic shock

About this article
Title

‘A blessing in disguise’: the severe course of perioperative takotsubo syndrome associated with favorable long-term outcome.

Journal

Folia Cardiologica

Issue

Vol 15, No 6 (2020)

Article type

Case report

Pages

419-422

Published online

2020-12-30

DOI

10.5603/FC.2020.0061

Bibliographic record

Folia Cardiologica 2020;15(6):419-422.

Keywords

takotsubo syndrome
thyroidectomy
cardiac arrest
cardiogenic shock

Authors

Konrad Stępień
Karol Nowak
Paweł Rostoff
Barbara Szlósarczyk
Adam Stępień
Jadwiga Nessler
Jarosław Zalewski

References (10)
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