title: Dental management of a patient with takotsubo cardiomyopathy: a case report.
abstract: Takotsubo cardiomyopathy (TCM) is a relatively new concept in cardiovascular disease. The clinical symptoms of TCM are similar to those of a myocardial infarction, but both the mechanism and the management of TCM are different from those of myocardial infarction. The cause of TCM is unclear, but it is suggested to occur in conjunction with excessive circulating catecholamines due to stress. Thus, control of the stress reaction and restriction of catecholamine levels are considered important for prevent of TCM onset. We report the dental management of a patient with intellectual disability who had anamnesis of TCM and cardiopulmonary arrest under restraint during a previous dental appointment in another dental clinic. We used intravenous sedation with both midazolam and propofol, by which the excessive hormonal reaction that caused TCM onset and cardiopulmonary arrest was controlled, for dental treatment in our facility. All planned dental treatment was then performed without any problems.
authors.affiliation: Department of Dental Anesthesiology, Okayama University Hospital, Okayama, Japan. higuti@md.okayama-u.ac.jp <higuti@md.okayama-u.ac.jp>
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Higuchi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Maeda
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyawaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kohjitani
authors.forename: Takayuki
authors.initials: T
authors.lastname: Mori
authors.forename: Ryo
authors.initials: R
authors.lastname: Ishida
authors.forename: Masahiko
authors.initials: M
authors.lastname: Egusa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D018686:Anesthetics, Intravenous; D009202:Cardiomyopathies / Q000150:complications*; D016292:Procedural Sedation / Q000379:methods*; D017742:Dental Care for Chronically Ill / Q000379:methods*; D005260:Female; D006801:Humans; D008874:Midazolam / Q000008:administration & dosage; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D015742:Propofol / Q000008:administration & dosage; D013315:Stress, Psychological / Q000150:complications
chemical_list: D018686:Anesthetics, Intravenous; D008874:Midazolam; D015742:Propofol