An atypical case of reverse Takotsubo cardiomyopathy during general anesthesia in a 30-year-old male with post-traumatic stress disorder.

摘要: AKOTSUBO CARDIOMYOPATHY, also referred to as transient left ventricular ballooning syndrome or stressinduced cardiomyopathy, describes a rapid-onset, yet reversible systolic dysfunction that typically is triggered by an acute, stressful event. The pathophysiology not completely understood, and similar presentations have been described result of the endocrine crisis pheochromocytoma, 1 subarachnoid hemorrhage, 2 Guillain-Barre syndrome. 3 A wide heterogeneity presentation suggests multiple overlapping mechanisms such neurogenic catecholamine-induced myocardial stunning, 4 microvascular dysfunction, 5 multivessel epicardial spasm 6,7 may play role. Symptoms mimic ST-segment elevation infarction. Patients present with ischemic electrocardiographic changes, reduced ejection fraction, balloon-like contractility pattern portrays unique wall-motion abnormality extends beyond territory single coronary artery. classic form presents apical basal hypercontractility. In more rare cases reverse Takotsubo, opposite observed—transient dilatation segments heart hyperkinesis apex. It has estimated 0.5% 2% patients symptoms acute Takotsubo cardiomyopathy. 7,8 Of these, 95% are postmenopausal women median age 63 years. For first time, authors case anesthesia-induced cardiomyopathy in young, healthy male history posttraumatic stress disorder (PTSD). this atypical patient, anesthesia, perioperative stressors, chronic psychologic distress ballooning.