Takotsubo syndrome after sigmoid perforation

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Gastroenterology

Background:

• Takotsubo syndrome (TTS) mimics acute coronary syndrome (ACS) with transient left ventricular dysfunction.
• Extracardiac symptoms can precede the cardiac manifestations in secondary TTS.
• Differential diagnosis of ACS in surgical patients is crucial.

Purpose of the Study:

• To report a case of Takotsubo syndrome in a surgical patient.
• To highlight the importance of considering TTS in the differential diagnosis of ACS in surgical settings.
• To emphasize the favorable prognosis of TTS with appropriate management.

Main Methods:

• A 67-year-old female with ischemic heart disease underwent Hartmann's resection for sigmoid perforation.
• Postoperatively, the patient developed cardiorespiratory failure with ECG and echocardiographic findings suggestive of ACS.
• Coronary angiography ruled out coronary artery involvement, leading to a TTS diagnosis.

Main Results:

• The patient presented with cardiorespiratory failure and new-onset left bundle branch block after abdominal surgery.
• Echocardiography revealed severe left ventricular systolic dysfunction and regional wall motion abnormalities.
• Coronary angiography excluded acute coronary syndrome, and Takotsubo syndrome was diagnosed.

Conclusions:

• Takotsubo syndrome should be considered in surgical patients presenting with symptoms suggestive of ACS.
• Prompt diagnosis and tailored therapy for TTS result in symptom resolution and complete recovery of left ventricular function.
• TTS, though potentially fatal, has a good prognosis with appropriate medical intervention.