J Yeungnam Med Sci.  2022 Apr;39(2):172-178. 10.12701/yujm.2021.01354.

Reverse Takotsubo cardiomyopathy with left bundle branch block after anesthesia induction in a patient with subarachnoid hemorrhage: a case report

• Choi EK
• Kim JH
• Kim M

• KMID: 2529277
• DOI: http://doi.org/10.12701/yujm.2021.01354

Abstract

Cardiac dysfunction after subarachnoid hemorrhage (SAH) is described as Takotsubo or reverse Takotsubo cardiomyopathy that shows transient left ventricular wall motion abnormalities with electrocardiogram (ECG) changes. ST change followed by T inversion is a common ECG finding complicated with these disorders, left bundle branch block (LBBB) may be a potential ECG pattern which is seen. In this case, we describe the clinical profile and outcomes of a patient with LBBB and reverse Takotsubo cardiomyopathy after anesthetic induction, which was scheduled as an emergent external ventricular drainage after SAH. This is the first report of an LBBB pattern in reverse Takotsubo cardiomyopathy.

Keyword

Anesthesia; Bundle-branch block; Electrocardiography; Subarachnoid hemorrhage; Takotsubo cardiomyopathy

Figure

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  Fig. 1. Preoperative electrocardiogram with normal sinus rhythm.

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  Fig. 2. Intraoperative electrocardiogram with left bundle branch block.

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  Fig. 3. Intraoperative transthoracic echocardiogram at the left bundle branch block. IVSd, interventricular septum diastolic; LVIDd, left ventricular internal dimension in diastole; LVPWd, left ventricular posterior wall thickness in diastole; LVIDs, left ventricular internal diameter systolic; EDV, end diastolic volume; ESV, end systolic volume; SV, stroke volume; EF, ejection fraction; FS, fractional shortening; LVM, left ventricular mass.

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  Fig. 4. Intraoperative transthoracic echocardiogram at the normal sinus rhythm. IVSd, interventricular septum diastolic; LVIDd, left ventricular internal dimension in diastole; LVPWd, left ventricular posterior wall thickness in diastole; LVIDs, left ventricular internal dimension in systole; EDV, end diastolic volume; ESV, end systolic volume; SV, stroke volume; EF, ejection fraction; FS, fractional shortening; LVM, left ventricular mass.

Reference

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