Reverse Takotsubo syndrome pattern induced by local anaesthesia

Tomcsányi, János; Arabadzisz, Hrisula; Frész, Tamás; Sármán, Balázs; Bózsik, Béla; Zsoldos, András; Símor, Tamás

doi:10.1556/oh.2008.28433

Cited by 8 publications

(2 citation statements)

References 7 publications

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“…As plasma levels of both catecholamines are highly elevated after stressful events, such as aneurysm rupture, it is difficult to determine which catecholamine plays a more active role in the pathogenesis of TTC and/or r-TTC. Unintentional (frequently iatrogenic) epinephrine administration may provide unique insight, because many cases of iatrogenic r-TTC have been associated with exogenous epinephrine administration in the literature [17], [18], [19], [20], [21], [22], [23], [24]. Our finding of extremely elevated epinephrine levels in patients with r-TTC may also support its etiological role.…”

Section: Discussionsupporting

confidence: 54%

Differences between Takotsubo cardiomyopathy and reverse Takotsubo cardiomyopathy associated with subarachnoid hemorrhage

Kumai

Inamasu

Watanabe

et al. 2016

IJC Heart & Vasculature

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BackgroundBoth Takotsubo cardiomyopathy (TTC) and reverse TTC (r-TTC) are characterized by reversible regional wall motion abnormalities of the heart unrelated to coronary artery pathology. It remains unclear whether and/or how r-TTC differs from TTC. Subarachnoid hemorrhage (SAH) is occasionally causative of TTC/r-TTC, and this study was conducted to detect possible differences between TTC and r-TTC associated with SAH.MethodsA single-center retrospective study was conducted on 328 consecutive SAH patients. They routinely underwent transthoracic echocardiography (TTE), ECG, and measurements of plasma catecholamines and other cardiac biomarkers within 24 h of admission. Demographic, echocardiographic, electrocardiographic and neurochemical profiles were compared between patients with TTC and r-TTC. The diagnosis of TTC/r-TTC was based on the revised Mayo Clinic Criteria.ResultsData of 21 SAH-induced TTC and 10 SAH-induced r-TTC patients admitted between January 2009 and December 2014 were analyzed. The patients with r-TTC were significantly younger than those with TTC (51.8 ± 10.9 vs. 63.5 ± 14.4 years, p = 0.04). The former exhibited significantly higher plasma epinephrine levels than the latter (809 ± 710 vs. 380 ± 391 pg/mL, p = 0.04). Plasma norepinephrine levels did not differ significantly (2421 ± 1374 vs. 1724 ± 1591 pg/mL, p = 0.25). No significant differences were observed in other demographic/physiologic variables, echocardiographic parameters, frequency of ECG abnormalities, and 90-day mortality. Moreover, none of the patients who underwent a follow-up TTE exhibited morphologic change from one type to the other.ConclusionsThe pathomechanisms in TTC and r-TTC may not be identical: however, distinguishing the two conditions may not have great importance from the standpoint of clinical management and prognostication.

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Section: Discussionsupporting

confidence: 54%

Differences between Takotsubo cardiomyopathy and reverse Takotsubo cardiomyopathy associated with subarachnoid hemorrhage

Kumai

Inamasu

Watanabe

et al. 2016

IJC Heart & Vasculature

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“…Tomcsanyi et al in 2008 presented the case of a 36 year old female who after an injection of lidocaine with adrenaline for plastic surgery of the ear developed inverted Takotsubo cardiomyopathy with akinesis of basal segments and hyperkinetic apex. The symptoms resolved and cardiac function recovered in 3 days [18]. In 2010 Gervais MK et al uncovered a pheocromocytoma initially presenting as cardiac failure secondary to inverted Takotsubo cardiomyopathy.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

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

Ruisi¹,

Lee²,

Rachko³

2011

J Clinic Experiment Cardiol

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Takotsubo cardiomyopathy is a reversible form of acute heart failure first described in Japan, believed to be triggered by major stressful events in a patient's life. The patient's clinical presentation in conjunction with ECG analysis, echocardiography, and angiography depicts an ischemic event leading to LV dysfunction with no evidence of an acute coronary syndrome. Classically, the cardiomyopathy manifests itself as apical akinesis and ballooning on echocardiography mimicking the likeness of an octopus trap. Less commonly there have been reports of an inverted pattern type of Takotsubo cardiomyopathy with preserved apical wall function. We present the case of a 43 year old female who developed a transient inverted variant of Takotsubu cardiomyopathy during an elective herniorrhaphy. A postoperative transthoracic echocardiogram revealed severely reduced LV function with akinesis of the basal and posterior walls with severe mitral regurgitation. Cardiac catheterization failed to reveal significant lesions, and an intra-aortic balloon pump was placed for cardiac support. Over the next 5 days the patient's clinical picture improved markedly with complete normalization of LV function.

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Reverse Takotsubo-Kardiomyopathie – eine lebensbedrohliche Erkrankung

Bleser

Weth

Görge

2013

Med Klin Intensivmed Notfmed

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We report on a 31-year-old woman requiring resuscitation because of ventricular fibrillation during a standard dental procedure with local anaesthesia. In cardiac ventriculography, reverse takotsubo cardiomyopathy was diagnosed. Because of protracted cardiogenic shock early treatment with calcium sensitizers, as well as the use of an intra-aortic ballon pump (IABP) were necessary to achieve stable hemodynamics. Despite a maximum neuron-specific enolase value of 37.8 ng/ml, the patient was released from the hospital 19 days after admission without a neurological deficit and with completely restored cardiac function.

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Reverse Takotsubo syndrome pattern induced by local anaesthesia

Cited by 8 publications

References 7 publications

Differences between Takotsubo cardiomyopathy and reverse Takotsubo cardiomyopathy associated with subarachnoid hemorrhage

Differences between Takotsubo cardiomyopathy and reverse Takotsubo cardiomyopathy associated with subarachnoid hemorrhage

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

Reverse Takotsubo-Kardiomyopathie – eine lebensbedrohliche Erkrankung

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