Takotsubo Cardiomyopathy Induced Intraoperative and Postoperative Cardiac Arrests

Takotsubo cardiomyopathy (TC) is a transient left ventricular apical ballooning syndrome which results in an acute, reversible, left ventricular dysfunction. Unlike a myocardial ischemia, TC is not due to coronary artery stenosis. Initially the syndrome was described by a series of five Japanese patients in 1991 [1] and there have been multiple subsequent reports. The syndrome received its name from an octopus trap (tako-tsubo) which is a wide pot that has a narrow opening. This trap resembles the left ventricle of a patient with TC during systole as the apex is rounded and balloons out despite a hypercontractile and narrow base. TC has also been called “broken heart syndrome” because it is usually associated with a stressful event. Although recurrent cases of TC have been reported, this is the first presentation of a patient that experienced recurrent TC induced cardiac arrest in the same perioperative period.