Takotsubo cardiomyopathy after cesarean section: A case report and literature review

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Sara Ruiz1, Miguel Martinez-Marin2, Pilar Luque3

  • 1Department of Obstetrics, Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.

The Journal of Obstetrics and Gynaecology Research
|December 10, 2016
PubMed

Takotsubo cardiomyopathy (TCM) is clinically identical to acute myocardial infarction. We report an unusual case of TCM and review similar cases in pregnant women. A young woman with no pre-existing cardiovascular risk factors suffered sudden dyspnea during a cesarean section. Electrocardiography (ECG) showed T-wave inversion. We observed acute lung edema and left ventricular systolic dysfunction on echocardiography. A cardiac catheterization diagnosed TCM. We reviewed 20 cases of TCM; 17 cases occurred during the post-partum period and three during pregnancy. Five of these cases had vaginal deliveries and the remaining cases had cesarean sections. Within the latter group, five cases appeared intraoperatively. With the exception of one patient with normal ECG results, all other patients progressed, with changes in ECG readings and elevation of cardiac enzyme serum levels. However, cardiac catheterization revealed that coronary arterial damage did not occur in any of the cases. After three months, each patient fully recovered.

Keywords:
Cesarean sectioncardiovascularcritical care obstetricsobstetric anesthesiapost dates

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