Inverted Takotsubo Syndrome With HELLP Syndrome: A Case Report

Gabarre, Paul; Ruiz, Pablo Rodríguez; Chenevier‐Gobeaux, Camille; Charpentier, Etienne; Soulat-Dufour, Laurie; Cohen, Ariel; Monnier‐Cholley, Laurence; Chemali, Lotfi; François, H.; Kernéis, Mathieu; Lefèvre, Guillaume; Boissan, Mathieu

doi:10.3389/fcvm.2022.832098

Cited by 3 publications

(2 citation statements)

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“…Fortunately, cardiac function fully recovered with no major adverse effects on the new-born baby. Gabarre et al described another case report of inverted Takotsubo syndrome in a patient with HELLP syndrome [ 106 ]. In this case, the woman had an uncomplicated spontaneous vaginal delivery, but she was given extremely distressing news about her child just after delivery: she soon showed signs of inverted Takotsubo syndrome.…”

Section: Special Setting and Populationmentioning

confidence: 99%

Perioperative management of Takotsubo cardiomyopathy: an overview

Pillitteri,

Brogi,

Piagnani

et al. 2024

J Anesth Analg Crit Care

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Resembling the morphology of Japanese polyp vessels, the classic form of Takotsubo cardiomyopathy is characterized by the presence of systolic dysfunction of the mid-apical portion of the left ventricle associated with basal hyperkinesia. It is believed that this may be due to a higher density of β-adrenergic receptors in the context of the apical myocardium, which could explain the greater sensitivity of the apex to fluctuations in catecholamine levels.The syndrome is precipitated by significant emotional stress or acute severe pathologies, and it is increasingly diagnosed during the perioperative period. Indeed, surgery, induction of general anaesthesia and critical illness represent potential harmful trigger of stress cardiomyopathy. No universally accepted guidelines are currently available, and, generally, the treatment of TTS relies on health care personal experience and/or local practice. In our daily practice, anaesthesiologists can be asked to manage patients with the diagnosis of new-onset Takotsubo before elective surgery or an emergent surgery in a patient with a concomitant stress cardiomyopathy. Even more, stress cardiomyopathy can arise as a complication during the operation.In this paper, we aim to provide an overview of Takotsubo syndrome and to discuss how to manage Takotsubo during surgery and in anaesthesiologic special settings.

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Section: Special Setting and Populationmentioning

confidence: 99%

Perioperative management of Takotsubo cardiomyopathy: an overview

Pillitteri,

Brogi,

Piagnani

et al. 2024

J Anesth Analg Crit Care

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“…The details of this case were presented in a previous report (8). In brief, a 38-year-old woman (gravida 2, para 0) was admitted to the delivery unit after a normal pregnancy with no pregnancy-induced hypertension.…”

Section: Case Presentationmentioning

confidence: 99%

Case report: Changes in the levels of stress hormones during Takotsubo syndrome

Ruiz

Gabarre

Chenevier‐Gobeaux

et al. 2022

Front. Cardiovasc. Med.

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BackgroundTakotsubo syndrome is an acute cardiac condition usually involving abnormal regional left ventricular wall motion and impaired left ventricular contractility. It is due mainly to hyper-stimulation of the sympathetic nerve system, inducing an excess of catecholamines, usually triggered by intense psychological or physiological stress. The relationship between Takotsubo syndrome and the circulating stress hormones cortisol and copeptin (a surrogate marker of arginine vasopressin) has not been well documented.Case summaryHere, we describe the dynamic changes in circulating cortisol and copeptin during an entire episode of Takotsubo syndrome in a post-partum woman after spontaneous vaginal delivery. The patient was diagnosed with inverted Takotsubo syndrome accompanied by HELLP syndrome. We found qualitative and quantitative changes in cortisol: a loss of circadian rhythm and a three-fold elevation in the plasma concentration of the hormone with a peak appearing several hours before circulating cardiac biomarkers began to rise. By contrast, levels of copeptin remained normal during the entire episode.DiscussionOur findings indicate that the levels of cortisol change during Takotsubo syndrome whereas those of copeptin do not. This association between elevated cortisol and Takotsubo syndrome suggests that aberrant levels of this stress hormone may contribute to the observed cardiac pathology. We conclude that biochemical assays of circulating cortisol and cardiac biomarkers may be a useful complement to the diagnosis of Takotsubo syndrome by non-invasive cardiac imaging.

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