Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(4):659-661 | DOI: 10.5507/bp.2013.005

An unusual reason for severe bradycardia leading to cardiac arrest during general anaesthesia: A case report

Klara Struzkovaa,c, Petr Stouraca, Jan Kanovskyb, Ivo Krikavaa, Michaela Toukalkovaa, Pavel Sevcika,d
a Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, Masaryk University, Brno and Faculty Hospital Brno, Czech Republic
b Department of Cardiology, Faculty of Medicine, Masaryk University, Brno and Faculty Hospital Brno
c 6th Field Hospital, Armed Forces of the Czech Republic
d Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine, University of Ostrava and Faculty Hospital Ostrava

Background: Takotsubo 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 Results: We 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.

Conclusion: Takotsubo 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.

Keywords: Takotsubo cardiomyopathy, cardiac arrest, levosimendan, general anaesthesia, severe bradycardia

Received: September 1, 2012; Accepted: January 17, 2013; Prepublished online: March 22, 2013; Published: December 9, 2014  Show citation

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Struzkova, K., Stourac, P., Kanovsky, J., Krikava, I., Toukalkova, M., & Sevcik, P. (2014). An unusual reason for severe bradycardia leading to cardiac arrest during general anaesthesia: A case report. Biomedical papers, 158(4), 659-661. doi: 10.5507/bp.2013.005
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