Acute Crit Care.  2020 Feb;35(1):51-55. 10.4266/acc.2018.00304.

Extracorporeal membrane oxygenation for takotsubo cardiomyopathy that developed after mitral valve replacement

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Seoul, Korea
  • 2Department of Anesthesiology and Pain Medicine, Seoul Sungsim General Hospital, Seoul, Korea
  • 3Department of Thoracic and Cardiovascular Surgery, Kyung Hee University School of Medicine, Seoul, Korea

Abstract

Takotsubo cardiomyopathy is a transient systolic and diastolic left ventricular dysfunction that presents several wall-motion abnormalities, while the coronary artery shows normal findings. Because patients with Takotsubo cardiomyopathy present with symptoms similar to acute coronary syndrome, the initial diagnosis and treatment are often difficult. The condition is often precipitated by acute emotional or physical stress and frequently occurs in postmenopausal women. Takotsubo cardiomyopathy may also occur in the perioperative period after cardiac and noncardiac surgery; surgery-associated Takotsubo cardiomyopathy reportedly accounts for 3%–23% of all cases. Of these perioperative cases, cardiothoracic surgery accounted for 16%. However, few cases have been reported in patients undergoing cardiac surgery and managed with extracorporeal membrane oxygenation (ECMO). We report a case of Takotsubo cardiomyopathy managed with ECMO in a patient in the intensive care unit after mitral valve replacement.

Keyword

extracorporeal membrane oxygenation; intensive care units; Takotsubo cardiomyopathy

Figure

  • Figure 1. Apical view of the left ventricle with akinesia of the apical and mid segments on transthoracic echocardiography. (A) Diastole. (B) Systole.

  • Figure 2. Changes in brain natriuretic peptide (BNP) (A) and troponin I (B) levels.


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