ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo

Brazilian Journal of Anesthesiology
Leticia Bôa-Hora RodriguesJoão Silva Duarte

Abstract

Takotsubo cardiomyopathy, also known as broken heart syndrome is a stress-induced cardiomyopathy, which can be interpreted as an acute coronary syndrome as it progresses with suggestive electrocardiographic changes. The purpose of this article is to show the importance of proper monitoring during surgery, as well as the presence of an interdisciplinary team to diagnose the syndrome. Male patient, 66 years old, with diagnosis of gastric carcinoma, scheduled for diagnostic laparoscopy and possible gastrectomy. In the intraoperative period during laparoscopy, the patient always remained hemodynamically stable, but after conversion to open surgery he presented with ST segment elevation in DII. ECG during surgery was performed and confirmed ST-segment elevation in the inferior wall. The cardiology team was contacted and indicated the emergency catheterization. As the surgery had not yet begun irreversible steps, we opted for the laparotomy closure, and the patient was immediately taken to the hemodynamic room where catheterization was performed showing no coronary injury. The patient was taken to the hospital room where an echocardiogram was performed and showed slight to moderate systolic dysfunction, with akinesia of the mid-apica...Continue Reading

References

Sep 1, 1994·Japanese Circulation Journal·O YamanakaH Yamaguchi
Mar 12, 2003·Journal of the American College of Cardiology·Yoshiteru AbeHitoshi Tanio
Apr 4, 2006·Heart Failure Reviews·Daniel Donohue, Mohammad-Reza Movahed
May 25, 2006·European Heart Journal·Monica GianniEva Lonn
Jul 27, 2007·International Journal of Cardiology·Thomas M Pilgrim, Thomas R Wyss

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Citations

Dec 15, 2015·Journal of Cardiac Surgery·Giovanni Alfonso ChiarielloMassimo Massetti
Jun 22, 2016·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Eugene A Hessel
Aug 23, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Menachem M WeinerHarish Ramakrishna
Feb 27, 2020·Case Reports in Anesthesiology·Patrick J LindsayMarvin G Chang

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