Takotsubo syndrome after sigmoid perforation

Takotsubo syndrome presents with the sudden onset of symptoms resembling with acute coronary syndrome with typical transient myocardial kinetic disorder. In the secondary form of the disease, the initial symptoms of the patient are extracardiac.

A 67-year-old female patient with a history of ischemic heart disease underwent urgent Hartmann's resection for sigmoid perforation due to Clostridium colitis. Two days after the primary surgery, during a planned surgical revision for another pathology, the patient developed cardiorespiratory failure. Due to the electrocardiographic finding of newly developed left bundle branch block and the echocardiographic image of extensive local kinetic disorder with severe systolic dysfunction of the left ventricle, the patient was indicated for selective coronary angiography with suspicion of acute coronary syndrome. The examination did not demonstrate coronary artery involvement. After the diagnosis of Takotsubo syndrome was established, the patient was successfully treated with gradual resolution of symptoms and normalization of left ventricular function.

Takotsubo syndrome is a diagnosis that can be potentially fatal and -should be a part of the differential diagnostic assessment in surgical patients when acute coronary syndrome is suspected. With properly adjusted therapy, the symptoms of this disease disappear without functional and morphological consequences.