ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo
ABSTRACTBACKGROUND AND OBJECTIVES: Takotsubo cardiomyopathy, also known as broken heart syndrome is a stress-induced cardiomyopathy, which can be interpreted as an acute coronary syndrome as it progresses with suggestive electrocardiographic changes. The purpose of this article is to show the import...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Anestesiologia
2015-10-01
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| Series: | Revista Brasileira de Anestesiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942015000500403&lng=en&tlng=en |
| _version_ | 1818941619908378624 |
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| author | Leticia Bôa-Hora Rodrigues Ana Batista Fátima Monteiro João Silva Duarte |
| author_facet | Leticia Bôa-Hora Rodrigues Ana Batista Fátima Monteiro João Silva Duarte |
| author_sort | Leticia Bôa-Hora Rodrigues |
| collection | DOAJ |
| description | ABSTRACTBACKGROUND AND OBJECTIVES: Takotsubo cardiomyopathy, also known as broken heart syndrome is a stress-induced cardiomyopathy, which can be interpreted as an acute coronary syndrome as it progresses with suggestive electrocardiographic changes. The purpose of this article is to show the importance of proper monitoring during surgery, as well as the presence of an interdisciplinary team to diagnose the syndrome.CASE REPORT: Male patient, 66 years old, with diagnosis of gastric carcinoma, scheduled for diagnostic laparoscopy and possible gastrectomy. In the intraoperative period during laparoscopy, the patient always remained hemodynamically stable, but after conversion to open surgery he presented with ST segment elevation in DII. ECG during surgery was performed and confirmed ST-segment elevation in the inferior wall. The cardiology team was contacted and indicated the emergency catheterization. As the surgery had not yet begun irreversible steps, we opted for the laparotomy closure, and the patient was immediately taken to the hemodynamic room where catheterization was performed showing no coronary injury. The patient was taken to the hospital room where an echocardiogram was performed and showed slight to moderate systolic dysfunction, with akinesia of the mid-apical segments, suggestive of apical ballooning of the left ventricle. Faced with such echocardiographic finding and in the absence of coronary injury, the patient was diagnosed with intraoperative Takotsubo syndrome.CONCLUSION: Because the patient was properly monitored, the early detection of ST-segment elevation was possible. The presence of an interdisciplinary team favored the syndrome early diagnosis, so the patient was again submitted to safely intervention, with the necessary security measures taken for an uneventful new surgical intervention. |
| first_indexed | 2024-12-20T06:58:25Z |
| format | Article |
| id | doaj.art-8d816a5e7531485a8d3cc95f259f0100 |
| institution | Directory Open Access Journal |
| issn | 1806-907X |
| language | English |
| last_indexed | 2024-12-20T06:58:25Z |
| publishDate | 2015-10-01 |
| publisher | Sociedade Brasileira de Anestesiologia |
| record_format | Article |
| series | Revista Brasileira de Anestesiologia |
| spelling | doaj.art-8d816a5e7531485a8d3cc95f259f01002022-12-21T19:49:16ZengSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia1806-907X2015-10-0165540340610.1016/j.bjane.2014.11.005S0034-70942015000500403ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsuboLeticia Bôa-Hora RodriguesAna BatistaFátima MonteiroJoão Silva DuarteABSTRACTBACKGROUND AND OBJECTIVES: Takotsubo cardiomyopathy, also known as broken heart syndrome is a stress-induced cardiomyopathy, which can be interpreted as an acute coronary syndrome as it progresses with suggestive electrocardiographic changes. The purpose of this article is to show the importance of proper monitoring during surgery, as well as the presence of an interdisciplinary team to diagnose the syndrome.CASE REPORT: Male patient, 66 years old, with diagnosis of gastric carcinoma, scheduled for diagnostic laparoscopy and possible gastrectomy. In the intraoperative period during laparoscopy, the patient always remained hemodynamically stable, but after conversion to open surgery he presented with ST segment elevation in DII. ECG during surgery was performed and confirmed ST-segment elevation in the inferior wall. The cardiology team was contacted and indicated the emergency catheterization. As the surgery had not yet begun irreversible steps, we opted for the laparotomy closure, and the patient was immediately taken to the hemodynamic room where catheterization was performed showing no coronary injury. The patient was taken to the hospital room where an echocardiogram was performed and showed slight to moderate systolic dysfunction, with akinesia of the mid-apical segments, suggestive of apical ballooning of the left ventricle. Faced with such echocardiographic finding and in the absence of coronary injury, the patient was diagnosed with intraoperative Takotsubo syndrome.CONCLUSION: Because the patient was properly monitored, the early detection of ST-segment elevation was possible. The presence of an interdisciplinary team favored the syndrome early diagnosis, so the patient was again submitted to safely intervention, with the necessary security measures taken for an uneventful new surgical intervention.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942015000500403&lng=en&tlng=enTakotsuboSíndrome coronária agudaAnestesia geralAnginaInfarto agudo do miocárdioChoque cardiogênico |
| spellingShingle | Leticia Bôa-Hora Rodrigues Ana Batista Fátima Monteiro João Silva Duarte ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo Revista Brasileira de Anestesiologia Takotsubo Síndrome coronária aguda Anestesia geral Angina Infarto agudo do miocárdio Choque cardiogênico |
| title | ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo |
| title_full | ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo |
| title_fullStr | ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo |
| title_full_unstemmed | ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo |
| title_short | ST-segment elevation during general anesthesia for non-cardiac surgery: a case of takotsubo |
| title_sort | st segment elevation during general anesthesia for non cardiac surgery a case of takotsubo |
| topic | Takotsubo Síndrome coronária aguda Anestesia geral Angina Infarto agudo do miocárdio Choque cardiogênico |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942015000500403&lng=en&tlng=en |
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