Intraoperative “Broken Heart” Cardiomyopathy with an “Inverted” Takotsubu Pattern

Ruisi, Michael; Lee, James; Rachko, Maurice

doi:10.4172/2155-9880.1000144

Cited by 3 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Women are more affected with Atherosclerosis [19]. At times increase in blood pressure may leads to various kinds of health problems [20,21]. Heart failure patients are at increased risk of sudden death due to ventricular problems [22,23,24].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Vasodilation and Arterial Resistance on Cardiac Output

Siddiqui¹

2011

J Clinic Experiment Cardiol

View full text Add to dashboard Cite

Heart is one of the most important organs present in human body which pumps blood throughout the body using blood vessels. With each heartbeat, blood is sent throughout the body, carrying oxygen and nutrients to all the cells in body. The cardiac cycle is the sequence of events that occurs when the heart beats. Blood pressure is maximum during systole, when the heart is pushing and minimum during diastole, when the heart is relaxed. Vasodilation caused by relaxation of smooth muscle cells in arteries causes an increase in blood flow. When blood vessels dilate, the blood flow is increased due to a decrease in vascular resistance. Therefore, dilation of arteries and arterioles leads to an immediate decrease in arterial blood pressure and heart rate. Cardiac output is the amount of blood ejected by the left ventricle in one minute. Cardiac output (CO) is the volume of blood being pumped by the heart, by left ventricle in the time interval of one minute. The effects of vasodilation, how the blood quantity increases and decreases along with the blood flow and the arterial blood flow and resistance on cardiac output is discussed in this review Article.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Most of the cardiovascular emergencies are caused by coronary artery disease [28,29]. Echocardiography is the modality of choice for investigation of suspected congenital or acquired heart disease [30,31,32,] Suspected heart disorders and related heart diseases can be investigated using Echocardiogram [33,34,35].…”

Section: Introductionmentioning

confidence: 99%

Effects of Vasodilation and Arterial Resistance on Cardiac Output

Siddiqui¹

2011

J Clinic Experiment Cardiol

View full text Add to dashboard Cite

show abstract

“…9 Apical form is the most common TCM to greater density of the adrenergic receptors and its vulnerable structure. 8,10 Therefore the heart is very sensitive to sympathetic stimulation, particularly there is strong apical reaction. 6 Thus, it is not enough to emphasize that TCM is hard to recognize especially in surgical and critical care medical population.…”

Section: Discussionmentioning

confidence: 99%

“…7 These all mechanisms associated with loss of estrogen protective role on vascular system in postmenopausal women lead to endothelial dysfunction resulting in the myocardial regional wall motion abnormalities as it was in our case. 7,8 Moreover, women are more prone to microvascular disease which also contributes the TCM development. 9 Apical form is the most common TCM to greater density of the adrenergic receptors and its vulnerable structure.…”

Section: Discussionmentioning

confidence: 99%

Role of echocardiography in stress cardiomyopathy diagnosis after tracheal extubation

Sakan¹,

Matošević

Pavlović

et al. 2017

Int J Res Med Sci

View full text Add to dashboard Cite

Stress cardiomyopathy or Takotsubo cardiomyopathy is a new syndrome and still insufficiently recognized among emergency patients, hospitalized patients. Many different physical and emotional stressors are triggers, but individual susceptibility to Takotsubo cardiomyopathy can not be predicted. Takotsubo cardiomyopathy in surgical and critical care population is a huge diagnostic challenge. Apart that these patients are treated in stressful environment and conditions. Postoperatively due to change of consciousness and inability to speak we can not rely on verbal symptoms to make differential diagnosis. Although essential sometimes they can not be submitted to coronary angiography to exclude obstructive coronary disease due many risk factors. So, then we follow clinical course, electrocardiographic, radiologic and echocardiographic dynamic changes, laboratory findings and consiliar opinion to make diagnosis. We represent a case of Takotsubo cardiomyopathy in a 59-years old postmenopausal Caucasian woman after tracheal extubation. She was submitted to surgery of intraabdominal collection evacuation in short general endotracheal anesthesia.

show abstract

Takotsubo Cardiomyopathy Induced by Epinephrine Infiltration for Liposuction: Broken Heart Syndrome

Maes¹,

Dhooghe²,

Schotte³

et al. 2019

Aesthetic Surgery Journal

View full text Add to dashboard Cite

Broken heart syndrome, more commonly known as Takotsubo cardiomyopathy (TCM), is an acute cardiac condition. It is characterized by regional cardiac wall motion abnormalities triggered by physical or emotional stress or administration of catecholamines such as epinephrine. The initial clinical presentation is similar to an acute coronary syndrome and must be ruled out. Visualization of the characteristic wall motion will trigger the diagnosis of TCM. In this case report, we present a 50-year-old woman with additional liposuction and fat grafting after autologous breast reconstruction. Shortly after infiltration with a solution containing epinephrine to achieve vasoconstriction, hypotension and bradycardia was noticed. This escalated into full asystole for which cardiac resuscitation was required. ST-elevations and a decrease in systolic function were clear indicators for urgent coronarography and ventriculography. These confirmed the diagnosis of TCM. Infiltration with epinephrine-containing products to achieve local vasoconstriction is used routinely. Medical professionals should be aware that this can trigger a TCM with an estimated mortality rate of 5%. No evidence of a specific preventive measure currently exists. We know that women with a neurologic or psychiatric comorbidity and high levels of stress are more at risk. Reducing stress and anxiolytic medication prior to surgery could be useful. We also know that the cardiac wall motion abnormality is mainly related to β-adrenoreceptors. The use of a selective α-adrenoreceptor agonist could be considered. Further research in the pathophysiology and incidence of TCM could improve identification of patients at risk and lead to more effective prevention and treatment. Level of Evidence: 5

show abstract

Intraoperative “Broken Heart” Cardiomyopathy with an “Inverted” Takotsubu Pattern

Cited by 3 publications

References 16 publications

Effects of Vasodilation and Arterial Resistance on Cardiac Output

Effects of Vasodilation and Arterial Resistance on Cardiac Output

Role of echocardiography in stress cardiomyopathy diagnosis after tracheal extubation

Takotsubo Cardiomyopathy Induced by Epinephrine Infiltration for Liposuction: Broken Heart Syndrome

Contact Info

Product

Resources

About