Reverse Takotsubo Cardiomyopathy: A Story of a Critically Ill Man with Transient Cardiac Dysfunction

Abstract

Reverse Takotsubo cardiomyopathy (TCM) is a recently described variant of classic TCM. In contrast to classic TCM, the regional wall motion abnormalities are localized in the basal segments. The condition can be triggered by acute stressful events, including acute medical illnesses. The wall motion abnormalities and left ventricular dysfunction are usually completely reversible. We present a case of an 84-year-old man with a complicated postoperative course after laparoscopic cholecystectomy with multiple laparotomies and recurrent sepsis. Echocardiographic evaluation demonstrated left ventricular dysfunction and wall motion abnormalities in a pattern resembling reverse TCM. He had no significant coronary disease on angiography and follow-up echocardiography showed complete resolution of left ventricular systolic dysfunction and regional wall motion abnormalities.

Acute Cholecystitis in a Gastric Bypass Patient Complicated by Takotsubo Cardiomyopathy

“…Aggarwal and Krantz described a TC case that occurred after cholecystitis and was resolved after cholecystectomy ( 11 ). Tori et al reported TC developing after cholecystectomy for gallstones and common bile stones ( 12 , 16 , 17 ). Viegas et al reported two cases of TC in the “early” postoperative period after bariatric surgery ( 15 ).…”

We Need to Rethink about Prophylactic Perioperative β-Blocker Therapy for Takotsubo Syndrome

“…I enjoyed reading the paper by Kakroo et al [1], published in the latest issue of Cardiology , about the 84-year-old man with a complicated postoperative course after laparoscopic cholecystectomy, duodenal and colonic perforation, with multiple laparotomies, right hemicolectomy, an ileostomy, and recurrent sepsis, who presented with reverse Takotsubo syndrome (TTS). Indeed this is a rare case, since reverse TTS is seen usually in younger subjects.…”