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Takotsubo Cardiomyopathy after Head and Neck Reconstructive Surgery
Masanori Mori1, Hayato Nagashima1, Satoshi Akazawa1
1Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan; Division of Cardiology, Shizuoka Cancer Center Hospital, Shizuoka, Japan; and Department of Plastic Surgery, Jichi Medical University, Tochigi, Japan.
Plastic and Reconstructive Surgery. Global Open
|July 26, 2017
Summary
Takotsubo cardiomyopathy (TCM), a transient heart failure, can mimic heart attacks after surgery. This study highlights 3 cases of TCM following head and neck reconstructive surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Takotsubo cardiomyopathy (TCM) is a transient heart failure mimicking acute coronary syndrome.
- Its pathophysiology remains incompletely understood.
- TCM is frequently associated with emotional or physical stressors and can occur postoperatively.
Observation:
- This report details 3 cases of TCM developing after head and neck reconstructive surgery.
- Echocardiography is crucial for diagnosing TCM, revealing left ventricular wall motion abnormalities extending beyond single coronary artery territories.
- Coronary angiography and cardiac CT confirm TCM by excluding coronary atherosclerosis.
Findings:
- Head and neck reconstructive surgery can precipitate Takotsubo cardiomyopathy.
- Careful fluid management is vital post-surgery to prevent dehydration and maintain flap viability.
- Congestive heart failure is the most frequent complication of TCM.
Implications:
- Early ambulation should be encouraged in TCM patients, balancing cardiac function.
- Increased awareness of TCM post-head and neck surgery is necessary for timely diagnosis and management.
- Understanding TCM triggers and complications aids in optimizing patient care pathways.
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