Intraoperative Takotsubo Cardiomyopathy: A Case Report

Area of Science:

• Cardiology
• Anesthesiology

Background:

• Takotsubo cardiomyopathy (TTC) is a rare heart condition characterized by temporary weakening of the heart's main pumping chamber.
• The exact cause of TTC is unknown, but excess catecholamines (stress hormones) are suspected to play a role in myocardial damage.

Purpose of the Study:

• To report a rare case of TTC triggered by local anesthesia with epinephrine during septorhinoplasty in an 18-year-old female.
• To highlight the importance of considering TTC in patients with unexplained hemodynamic instability post-cardiac resuscitation.

Main Methods:

• Case report of an 18-year-old female undergoing septorhinoplasty.
• Administration of local anesthesia containing lidocaine and epinephrine.
• Monitoring for adverse cardiac events, including tachycardia and cardiac collapse.

Main Results:

• The patient developed tachycardia storms and cardiac collapse immediately after local anesthesia administration.
• Subsequent evaluation confirmed Takotsubo cardiomyopathy as the cause of the cardiac event.
• The patient experienced treatment-resistant hemodynamic problems post-resuscitation.

Conclusions:

• Takotsubo cardiomyopathy should be considered in cases of refractory hemodynamic compromise after cardiac resuscitation, particularly following procedures involving catecholamine administration.
• Nurses play a critical role in preanesthetic care by managing patient stress, which may mitigate TTC risk.