• Klara Struzkova, Petr Stourac, Jan Kanovsky, Ivo Krikava, Michaela Toukalkova, and Pavel Sevcik.
• Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University, Brno and Faculty Hospital Brno, Czech Republic.
• Biomed Pap. 2014 Dec 1; 158 (4): 659-61.

BackgroundTakotsubo 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.Methods And ResultsWe 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.ConclusionTakotsubo 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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