An unusual reason for severe bradycardia leading to cardiac arrest during general anaesthesia: A case report

Authors

STRUŽKOVÁ Klára ŠTOURAČ Petr KAŇOVSKÝ Jan KŘIKAVA Ivo ŤOUKÁLKOVÁ Michaela ŠEVČÍK Pavel

Year of publication 2014
Type Article in Periodical
Magazine / Source Biomedical Papers of the Faculty of Medicine of Palacký University
MU Faculty or unit

Faculty of Medicine

Citation
Web http://biomed.papers.upol.cz/magno/bio/2013/mn2.php
Doi http://dx.doi.org/10.5507/bp.2013.005
Field Other medical specializations
Keywords Takotsubo cardiomyopathy; cardiac arrest; levosimendan; general anaesthesia; severe bradycardia
Attached files
Description Takotsubo Cardiomyopathy also known as transient balooning syndrome is an increasingly reported phenomenon characterized by acute reversible apical or midventricular dysfunction. This stress- induced cardiomyopathy mimics myocardial infarction, but without significant coronary artery disease, and rarely presents in perioperative period. We report a case of postmenopausal woman scheduled to undergo elective cholecystectomy, with no history of coronary artery disease. She presented perioperatively with Takotsubo Cardiomyopathy by unique manifestation- asystoly. This uncommon cause of cardiac arrest during anaesthesia was possibly induced by preoperative emotional stress. There was full recovery thanks to intensive management. In Takotsubo Cardiomyopathy related cardiogenic shock we used the calcium sensitiser levosimendan successfully. Takotsubo cardiomyopathy has an excellent long-term prognosis and nearly all patients have full recovery of left ventricular function. We emphasize the importance of heavy premedication by stress compromised patients and the need of sufficiently deep anaesthesia and analgesia during surgeries.

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