Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

Hessel, Eugene A.

doi:10.1007/s12630-016-0680-4

Cited by 45 publications

(82 citation statements)

References 193 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1][2][3][4] The dynamic ST/T alterations on ECG in the inferior and lateral leads without reciprocal ST depression in the other leads are the typical feature of TTC, in the absence of epicardial coronary artery disease, pheochromocytoma, or myocarditis. [1,2] Although the exact pathophysiological pathway of TTC still remains unclear, catecholamine-mediated myocardial stunning including an acute multi-vessel coronary spasm and coronary microcirculation dysfunction has been suggested to play a key role. [2] Exposure to emotional or physical stress and exaggerated sympathetic activity leads to secretion of excessive catecholamine production and, therefore, it has been suggested that those catecholamine molecules are directly related with myocardium injury.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2] It is particularly important for the differential diagnosis of dynamic ECG alterations following lung transplantation (LuTx), due to common occurrence in patients in the intensive care unit, and is often mistaken for other acute cardiac syndromes with poor prognosis. [3] However, TTC associated with LuTx has been reported in a very limited number of patients to date.…”

mentioning

confidence: 99%

See 1 more Smart Citation

An uncommon cause for grade 3 primary graft dysfunction after lung transplantation: Takotsubo cardiomyopathy

Yazicioğlu

Subaşı

Türkkan

et al. 2018

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

ÖZTakotsubo kardiyomiyopatisi akut, geçici bir kardiyak sendrom olup dinamik elektrokardiyografi değişikliklerinin ayırıcı tanısında önemlidir. Literatürde, akciğer nakli ile ilişkili Takotsubo kardiyomiyopatisi oldukça nadir olup sadece iki olgu sunumu bulunmaktadır. Olgumuz akciğer nakli sonrası erken dönemde ortaya çıkan ilk Takotsubo kardiyomiyopatisi olgusudur. Bu yazıda, kronik obstrüktif akciğer hastalığı nedeniyle çift taraflı, ardışık akciğer nakli uygulanan 61 yaşında bir erkek hasta sunuldu. Takipte Takotsubo kardiyomiyopatisi tanısı konuldu, kardiyomiyopati ile ilişkili primer greft disfonksiyonu gözlendi ve ekstrakorporeal membran oksijenasyonuna gereksinim duyuldu.Anah tar söz cük ler: Kardiyomiyopati; greft disfonksiyonu; akciğer nakli; Takotsubo. ABSTRACTTakotusubo cardiomyopathy is an acute, temporary cardiac syndrome which is important for the differential diagnosis of dynamic electrocardiography alterations. Takotsubo cardiomyopathy related to lung transplantation is rather rare in the literature with only two case reports. Our case is the first Takotsubo cardiomyopathy case that manifested in the early period after lung transplantation. In this article, we present a 61-yearold male patient who was performed bilateral sequential lung transplantation for chronic obstructive pulmonary disease. During follow-up, Takotsubo cardiomyopathy was diagnosed, primary graft dysfunction related to cardiomyopathy was observed, and extracorporeal membrane oxygenation was required.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

An uncommon cause for grade 3 primary graft dysfunction after lung transplantation: Takotsubo cardiomyopathy

Yazicioğlu

Subaşı

Türkkan

et al. 2018

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

show abstract

“…As this condition is most likely under-diagnosed it is important to have a tool that can aid in early identification. 4,7 Access to and training in POCUS is a useful tool in the hands of the anesthesiologist, and is applicable to other fields of medicine.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 While the majority of cases involve females, younger males seem to be at higher risk in the perioperative period. 6,7 The prevalence of Takotsubo cardiomyopathy among perioperative patients is estimated at 1:6700, and therefore should be understood by the practicing anesthesiologist. 7 We describe a case in which a patient presented to the operating room for an elective orthopedic procedure and developed a pulseless electrical activity arrest.…”

mentioning

confidence: 99%

“…6,7 The prevalence of Takotsubo cardiomyopathy among perioperative patients is estimated at 1:6700, and therefore should be understood by the practicing anesthesiologist. 7 We describe a case in which a patient presented to the operating room for an elective orthopedic procedure and developed a pulseless electrical activity arrest. Early use of POCUS by the anesthesiologist demonstrated findings keeping with Takotsubo cardiomyopathy and was useful in guiding early management.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The use of point of care ultrasonography in the perioperative period: A case of Takotsubo cardiomyopathy

Humphreys

Gallacher

2017

DMJ

View full text Add to dashboard Cite

Peri‐operative Takotsubo syndrome after non‐cardiac surgery: a retrospective nested case–control study

et al. 2022

View full text Add to dashboard Cite

Aims Takotsubo syndrome (TTS) is an acute reversible cardiac dysfunction that may occur during the peri‐operative period and among patients with serious illness. We aimed to evaluate the clinical characteristics, peri‐operative management, and prognosis of peri‐operative TTS (pTTS) and explore the factors associated with pTTS. Methods We conducted a retrospective nested case–control study using the database of patients who underwent in‐hospital non‐cardiac surgeries between January 2017 and December 2020 in Peking University Third hospital. Cases were adult patients diagnosed TTS at discharge who were matched with four controls based on operative types. Multivariable conditional logistic regression was used to identified the factors associated with pTTS. The area under the curve (AUC) was used to evaluate the diagnostic efficacy. Results Among the 128 536 patients underwent non‐cardiac surgery, 20 patients with pTTS and 80 patients without were enrolled in this study. The incidence of pTTS was about 0.016% in our centre. The median age of patients with pTTS was 52.5 (38.25, 76.25) years, although 90% of them were female. Fifty per cent (9 cases) of female patients were pre‐menopausal. Caesarean section has the highest proportion of pTTS (30% of the pTTS cases) with the incidence of caesarean section‐related pTTS of 0.06% in our centre. A high prevalence of non‐apical ballooning pattern of regional wall motion abnormality (seven cases, 35%) and a high mortality (two cases, 10%) were observed. Left ventricular ejection fraction (LVEF) of patients with pTTS was significantly decreased (41.7 ± 8.8%). In the acute phase, supportive treatments aiming to reduce life‐threatening complications were main treatment strategies. After receiving systematic treatment, significant improvements were observed in LVEF (63.1 ± 13.5%), with median recovery time of LVEF of 7.48 days. Leucocyte count [odds ratio (OR): 4.59; 95% confidence interval (CI): 1.10–19.15], haemoglobin (HGB) (OR: 10.52; 95% CI: 1.04–106.36), and the revised cardiac risk index (RCRI) score (OR: 6.30; 95% CI: 1.05–37.88) were the factors significantly associated with pTTS. The RCRI score performed poorly in the prediction of pTTS (AUC: 0.630; 95% CI: 0.525–0.735). After adding leucocyte count and HGB into the RCRI score, the AUC was significantly improved (AUC: 0.768; 95% CI: 0.671–0.865; P = 0.001). Conclusions Patients with pTTS have some differences compared with common TTS, including higher proportion of pre‐menopausal female, higher prevalence during caesarean section, higher prevalence of non‐apical ballooning pattern of regional wall motion abnormality, and higher mortality. The RCRI score performed poorly in the evaluation of pTTS. Adding HGB and leucocyte count into the RCRI score could significantly improve its predictive performance.

show abstract

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

Cited by 45 publications

References 193 publications

An uncommon cause for grade 3 primary graft dysfunction after lung transplantation: Takotsubo cardiomyopathy

An uncommon cause for grade 3 primary graft dysfunction after lung transplantation: Takotsubo cardiomyopathy

The use of point of care ultrasonography in the perioperative period: A case of Takotsubo cardiomyopathy

Peri‐operative Takotsubo syndrome after non‐cardiac surgery: a retrospective nested case–control study

Contact Info

Product

Resources

About