Takotsubo cardiomyopathy, or stress-induced cardiomyopathy, is a clinical syndrome mimicking acute myocardial infarction. We report a case of a 55-year-old man who developed Takotsubo cardiomyopathy during emergence from general anaesthesia for an elective procedure to remove a spinal cord stimulator. The perioperative state is known to induce stress, but there are few cases describing the onset of Takotsubo syndrome during this period. The case presented demonstrates that Takotsubo cardiomyopathy may occur on emergence from anaesthesia and that the pattern of left ventricular dysfunction produced may not be typical.
SatoH., TateishiH., UchidaT.Tako-tsubo-like left ventricular dysfunction due to multivessel coronary spasm. In: KodarnaK., HazeK., HoriM., eds. Clinical aspect of myocardial injury: from ischemia to heart failure.Tokyo: Kagakuhyoronsha Publishing Co1990. p. 56–64.
2.
MiyoshiS., HaraY., OgimotoA., ShigematsuY., OkuraT., HigakiJ.[Repeated changes of electrocardiogram caused by Takotsubo-type cardiomyopathy: a case with hypertrophic nonobstructive cardiomyopathy] (Japanese). Nippon Ronen Igakkai Zasshi2005; 42: 112–115.
3.
AkashiY.J., AnkerS.D.Takotsubo cardiomyopathy. Int J Cardiol2006; 112: 114–115.
4.
FinnB.C., YoungP., BruetmanJ.E.[Takotsubo, reversible apical ballooning of the left ventricle. Report of 4 cases] (Spanish). Medicina (B Aires)2005; 65: 415–418.
5.
GianniM., DentaliF., GrandiA.M., SumnerG., HiralalR., LonnE.Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J2006; 27: 1523–1529.
6.
OguraR., HiasaY., TakahashiT., YamaguchiK., FujiwaraK., OharaY.Specific findings of the standard 12-lead ECG in patients with ‘Takotsubo’ cardiomyopathy: comparison with the findings of acute anterior myocardial infarction. Circ J2003; 67: 687–690.
7.
WittsteinI.S., ThiemannD.R., LimaJ.A., BaughmanK.L., SchulmanS.P., GerstenblithG.Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med2005; 352: 539–548.
8.
PrasadA., LermanA., RihalC.S.Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J2008; 155: 408–417.
9.
OtomoS., SugitaM., ShimodaO., TerasakiH.Two cases of transient left ventricular apical ballooning syndrome associated with subarachnoid hemorrhage. Anesth Anaig2006; 103: 583–586.
10.
GavishD., RozenmanY., HafnerR., BartovE., EzriT.Takotsubo cardiomyopathy after general anesthesia for eye surgery. Anesthesiology2006; 105: 621–623.
11.
JabaudonM., BonninM., BolandardF., ChanseaumeS., DauphinC., BazinJ.E.Takotsubo syndrome during induction of general anaesthesia. Anaesthesia2007; 62: 519–523.
BoulmierD., BazinP.[Myocardial pseudo-infarction: “stress”– associated catecholamine-induced acute cardiomyopathy or coronary spasm?] (French). Ann Cardiol Angeiol (Paris)2000; 49: 449–454.
14.
ParodiG., AntoniucciD.Transient left ventricular apical ballooning syndrome after inadvertent epidural administration of potassium chloride. Int J Cardiol2008; 124: e14–15.
15.
BybeeK.A., KaraT., PrasadA., LermanA., BarsnessG.W., WrightR.S.Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med2004; 141: 858–865.
16.
HurstR.T., AskewJ.W., ReussC.S., LeeR.W., SweeneyJ.P., FortuinF.D.Transient midventricular ballooning syndrome: a new variant. J Am Coll Cardiol2006; 48: 579–583.
17.
SteenH., MertenC., KatusH.A., GiannitsisE.Images in cardiovascular medicine. A rare form of midventricular Tako-Tsubo after emotional stress followed up with magnetic resonance imaging. Circulation2006; 114: e248.
