Stress cardiomyopathy following acute ischemic stroke during flexible bronchoscopy: a rare sequence of complications

Badovinac, Sonja; Koršić, Marta; Čučević, Branka; Slivnjak, Valentina; Dugac, Andrea Vukić; Jakopović, Marko

doi:10.1590/s1806-37132013000400020

Cited by 4 publications

(3 citation statements)

References 9 publications

(18 reference statements)

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“…Searching the appropriate literature according to the criteria mentioned above revealed that TTS has been reported in association with ischemic stroke in more than 20 cases so far [100][101][102][103][104][105][106][107][108][109][110][111][112][113]. No systematic studies on the prevalence of TTS in ischemic stroke have been carried out.…”

Section: Ischemic Strokementioning

confidence: 99%

CNS disease triggering Takotsubo stress cardiomyopathy

Finsterer

Wahbi

2014

International Journal of Cardiology

119

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Section: Ischemic Strokementioning

confidence: 99%

CNS disease triggering Takotsubo stress cardiomyopathy

Finsterer

Wahbi

2014

International Journal of Cardiology

119

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“…There are a few reports of takotsubo cardiomyopathy induced by flexible bronchoscopy which may be attributed to over-released catecholamines due to the extreme stress [9][10][11][12]. The manifestation of Takotsubo syndrome could be similar to AMI, and it is characterized by transient left ventricular dysfunction and ballooning of the apical part of the left ventricular with reduced LVEF [13,14].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

Liu

Wang

2020

BMC Cardiovasc Disord

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Background It is increasingly recognized that a significant proportion of patients suffered from acute myocardial infraction (AMI) who did not have obstructive coronary artery disease (≥50% diameter stenosis). The term “MINOCA (myocardial infarction with nonobstructive coronary arteries)” was coined for such entity, however, the exact mechanism of MINOCA is still unclear. Herein, we report a patient with MINOCA during bronchoscopy and further review the recent literature. Case presentation A 65-year-old woman was hospitalized with the main complaint of chest tightness, nausea and vomiting for 30 min during bronchoscopy under local anesthesia. Immediate electrocardiogram (ECG) showed ST-segments elevation in leads V2–6 compared with those at admission, and the further evolvement of leads V2–3 into pathological Q wave. Serum cardiac biomarkers revealed high-sensitive cardiac troponin T (hs-cTnT) levels of 20.12 ng/L and 674.6 ng/L at the peak (normal range 0-14 ng/L). Emergency coronary angiography (CAG) showed only approximate 30% stenosis in the left anterior descending (LAD) ostium and 40% stenosis in the first diagonal branch (D1), with quantitative flow ratio (QFR) value for LAD of 0.96. Moreover, her echocardiographic examination presented new significant abnormal wall motion (anterior ventricular wall) with an estimated left ventricular ejection fraction (LVEF) of 62.1% after the cardiac attack. Thoracic enhanced CT scanning indicated no obvious sign of pulmonary embolism. Therefore, with confirmed AMI and the absence of significant coronary stenosis simultaneously, MINOCA was diagnosed with the prescription of dual-antiplatelet, statins, beta-blocker, angiotensin receptors antagonist, calcium channel blocker and nitrate. This patient had a good prognosis during a follow-up of 14 months. Conclusion In this case, bronchoscopy might have caused extremely tense and anxious which led to a sympathetic hyperfunction and acute coronary thrombosis induced by plaque disruption and coronary artery spasm. QFR value is a feasible technique to evaluate the functional coronary stenosis and assist the diagnose of MINOCA. Also, the diagnosis of MINOCA deems an exploration of underlying causes for proper management and prognostic evaluation.

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“…However, complications, including isolated excessive coughing, excessive nausea reflex with coughing, oxygen desaturation to < 90%, and even death [2][3][4][5] , may occur. A report by Suratt et al 6 suggests that a major reason for mortality due to bronchoscopy may be related to pre-surgery anesthesia, and three cases of generalized seizures caused by lidocaine are presented.…”

Section: ■ Introductionmentioning

confidence: 99%

A study on reducing the absorption of lidocaine from the airway in cats

2017

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Purpose: To determine if the combination of lidocaine with epinephrine or gamma globulin would decrease the rate or reduce the amount of local absorption of lidocaine through the airway. Methods: Twenty adult male cats were randomly and evenly distributed into four groups: 1) Group LG: lidocaine administered with gamma globulin; 2) Group LS: lidocaine administered with physiological saline); 3) Group LE: lidocaine administered with epinephrine; 4) Group C: control group. Invasive blood pressure, heart rate, and concentration of lidocaine were recorded before and after administration. Results: The peak of plasma concentrations appeared difference (Group LG: 1.39 ± 0.23 mg/L; Group LS: 1.47 ± 0.29 mg/L and Group LE: 0.99 ± 0.08 mg/L). Compared to Group C, there were significant differences in the average heart rate of Groups LG, LS, and LE (P < 0.05). The average systolic blood pressures were significantly different when each group was compared to Group C (P < 0.05). The biological half-life, AUC 0-120 , peak time, and half-life of absorption among the three groups have not presented statistically significant differences (P > 0.05). Conclusion: Administering lidocaine in combination with gamma globulin through airway causes significant decrease the rate and reduce the amount of local absorption of lidocaine in cats.

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Stress cardiomyopathy following acute ischemic stroke during flexible bronchoscopy: a rare sequence of complications

Cited by 4 publications

References 9 publications

CNS disease triggering Takotsubo stress cardiomyopathy

CNS disease triggering Takotsubo stress cardiomyopathy

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

A study on reducing the absorption of lidocaine from the airway in cats

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