Takotsubo cardiomyopathy occurring after cardiopulmonary bypass for cabg operation. A casereportsof takotsubo

The cardiomyopathy is often observed after intense stressful events such as a major surgical procedure. In a recent study, demographic and clinical course data in patients with Takotsubo cardiomyopathy were compared between the United States and Japan. Few Japanese patients with Takotsubo cardiomyopathy had a history of overt coronary disease (CAD) and family history of early-onset CAD (Kazuo Komamura et al., 2014). Methods: An Iranian 78 years old woman with Hypertension and IDDM, with previous CVA suddenly showed a greatly increased heart rate, and an electrocardiogram revealed elevated ST-segments. After preoperative examination she accepted for emergency CABG. We diagnosed the condition as takotsubo cardiomyopathy (acute left ventricle apical ballooning syndrome), possibly caused by catecholamine release and regional stress-induced ischemia. We reviewed the literature on takotsubo cardiomyopathy as a complication of major cardiac surgery procedures. Core tip: Takotsubo cardiomyopathy (TCM) occurs more often in postmenopausal elderly women, is characterized by a transient hypokinesis of the left ventricular (LV) apex and is associated with emotional or physical stress. TCM is an important disease entity that differs from acute myocardial infarction. Wall motion abnormality of the LV apex is generally transient and resolves within a few days to several weeks. The prognosis of TCM is generally good. It has been suggested that coronary spasm, coronary microvascular dysfunction, catecholamine toxicity and myocarditis might contribute to the pathogenesis of TCM. However, its pathophysiology is not clearly understood.