Shining a light on perioperative Takotsubo syndrome

Hessel, Eugene A.

doi:10.1007/s12630-021-02108-w

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…Takotsubo syndrome was first described more than 30 years ago, and its perioperative appearance was recognized up to 10 years later. Reports have reported that 3-17% of cases have been associated with surgical procedures [ 5 ]. Many hypotheses have been generated around cause and pathogenesis; however, endogenous adrenergic augmentation is the most established theory and is intuitive given the strong association with sudden and unexpected stress and a major physical illness or trauma [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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A Postoperative Complication of Takotsubo Syndrome in the Spinal Surgery: A Case Report

Ramírez-Aragón,

Del Pino-Camposeco,

Villanueva-Castro

et al. 2023

Cureus

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We present the case of a 32-year-old woman with a diagnosis of lumbar root syndrome and spondylolisthesis, which is why she underwent surgery. Anterior discectomy and intersomatic box placement plus posterior fixation were performed with percutaneous transpedicular screws in L5-S1. At 24 hours of the procedure, the patient presents sustained hypotension, adding sudden and intense chest pain with neck irradiation, dyspnea, and diaphoresis, as well as electrocardiographic abnormalities and elevation of cardiac enzymes suggestive of an acute coronary syndrome, subsequently evidence of basal hypokinesis in the echocardiogram. After providing hemodynamic support and analgesic management, the symptoms were resolved, and the electrocardiogram (ECG) and cardiac enzymes were normalized, allowing an adequate postoperative evolution.

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Section: Discussionmentioning

confidence: 99%

“…It has been noted in outpatient and inpatient scenarios, critical care units, and the perioperative environment [ 4 ]. However, very few case reports have been made describing the appearance of this syndrome as a complication of neurosurgery, specifically spinal [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Postoperative Complication of Takotsubo Syndrome in the Spinal Surgery: A Case Report

Ramírez-Aragón,

Del Pino-Camposeco,

Villanueva-Castro

et al. 2023

Cureus

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“…However, it should be noted that our result was based on a relatively small sample size, and we will further verify it in the cohort study. The management of pTTS remains challenging, 32 and there are no randomized clinical trials on specific therapeutic strategies of pTTS. Many authors have emphasized the importance of avoiding psychological stress in the peri-operative period by use of psychological and pharmacologic approaches, including pre-operative deep anxiolysis, adequate level of anaesthesia during the procedure, optimal post-operative analgesia and sedation, and administration of prophylactic beta-adrenergic blocking agents.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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“…По результатам исследования Guzzo G. et al (2021), среди 305906 пациентов, подвергшихся оперативному вмешательству по разным причинам в госпитале Буэнос-Айреса в период с 2008-2017гг, СТ развился у 21 больных: у 6 (29 %) человек СТ случился во время операции, у 7 (33 %) пациентов в течение первых трех суток и у 8 (38 %) больных СТ возник на четвертые сутки и позже, при этом в периоперационном периоде СТ чаще развивался у мужчин. Кроме того, автор обращает внимание, что 13 (60 %) операций были плановыми, а 10 (49 %) считались операциями низкого или среднего риска СТ [2,3]. По данным Brooks JK et al, за период с 1991 по 2018гг.…”

Section: Introductionunclassified

A Clinical Case of Takotsubo Syndrome in the Early Postoperative Period of Rhinoplasty

Болдуева

Feoktistova

Evdokimov

et al. 2022

Arhivʺ vnutrennej mediciny

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Takotsubo syndrome (TS) is an acute reversible left ventricular myocardial dysfunction caused by an emotional or physical trigger. In the perioperative period, TS is in some cases induced by various psychological factors, such as stress before/after surgery, and non-psychological factors, such as drug administration. This article describes the clinical observation of takotsubo syndrome that developed in the early postoperative period of rhinoplasty

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Shining a light on perioperative Takotsubo syndrome

Cited by 3 publications

References 15 publications

A Postoperative Complication of Takotsubo Syndrome in the Spinal Surgery: A Case Report

A Postoperative Complication of Takotsubo Syndrome in the Spinal Surgery: A Case Report

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

A Clinical Case of Takotsubo Syndrome in the Early Postoperative Period of Rhinoplasty

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