Abordagem perioperatória de doente com síndrome de takotsubo

Barros, Joana; Gomes, Daniel de Oliveira; Caramelo, Susana; Pereira, Marta

doi:10.1016/j.bjan.2014.11.003

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Anesthetic management of patients with TC requires special care throughout the perioperative period. Cases of patients with a confirmed diagnosis of TC during anesthesia in perioperative period were reported (5,6,7,18). Proper monitoring during surgery is important as well as team of experts for treating this syndrome (2).…”

Section: Discussionmentioning

confidence: 99%

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Takotsubo Cardiomyopathy Precipitated By Thyroidectomy - A Case Report

Vujović

Stefanović

Matić

et al. 2021

Serbian Journal of Experimental and Clinical Research

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Takotsubo cardiomyopathy (TC) is an acute cardiac condition triggered by emotional or physical stress. General anesthesia and sympathetic activation are possible triggers for TC. However, little is known about the role of sympathovagal activity in TC. In our report, we present a female patient, aged 62, who underwent thyroidectomy and at the end of the surgery developed cardiac complications. The patient had no chest pain, but had ST depression and negative T waves on the electrocardiogram (ECG). Cardiospecific enzyme troponin was elevated. Cardiac catheterization revealed unobstructed coronary arteries. Echo-cardiography revealed the enlargement of the left ventricle and ejection fraction of 40%. The patient was diagnosed with TC and dual antiplatelet therapy was introduced, a beta blocker and ACE inhibitor.It is possible that TC in perioperative period after thyroidectomy in this patient occured due to both sympathetic and parasympathetic activation. Probably, extraction of large thyroid induced vagal stimulation which resulted in hypotension and bradicardia. The patient was subsequently treated with adrenaline and atropine. In this case, sympathetic and parasympathetic activation in different intervals could result in the development of this condition.

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Section: Discussionmentioning

confidence: 99%

“…The pathophysiology of TC is not well established (5). However, some possible etiological factors have been proposed, such as catecholamine cardiotoxicity, metabolic disturbances, impairment of coronary microvascular circulation and multivessel epicardial coronary artery spasm (8).…”

Section: Introductionmentioning

confidence: 99%

Takotsubo Cardiomyopathy Precipitated By Thyroidectomy - A Case Report

Vujović

Stefanović

Matić

et al. 2021

Serbian Journal of Experimental and Clinical Research

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“…Many of these patients may require observation overnight in an intensive care unit given the potential for a TCM episode in the immediate postoperative period. [2367]…”

Section: Management and Prognosismentioning

confidence: 99%

Perioperative takotsubo cardiomyopathy: Implications for anesthesiologist

et al. 2019

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Takotsubo cardiomyopathy (TCM) is characterized by transient ventricular dysfunction in the absence of obstructive coronary artery disease that may be triggered by an acute medical illness or intense physical or emotional stress. TCM is often confused with acute myocardial infarction given the similar electrocardiographic changes, cardiac enzymes, hemodynamic perturbations, and myocardial wall motion abnormalities. In the perioperative setting, the clinical picture may be more confusing because of the effect of anesthesia as well as hemodynamic changes related to the surgery itself. However, awareness of various other diagnostic modalities may enable clinicians to distinguish between the two, more systematically and with greater certainty. Despite the large body of literature, there still seems to be an overall paucity in our understanding of the etiopathogenesis, clinical characteristics, natural history, and management of this syndrome, especially in the perioperative setting. This narrative review seeks to present and synthesize the most recent literature on TCM and to identify gaps in current knowledge which can become the basis for future research.

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