title: [Anesthetic management in a patient previously diagnosed with takotsubo cardiomyopathy].
abstract: Takotsubo cardiomyopathy (transient apical ballooning of the left ventricle) is a recently described and often underdiagnosed entity. The syndrome is observed predominately in postmenopausal women and the clinical signs are similar to those of an acute anterior myocardial infarction. In most of the reported cases an emotional or physical stress event has been identified as a trigger, and perioperative stress has been suggested as the trigger in some of these cases. Outcome is favorable with the right treatment, though recurrences are possible. We report the anesthetic management of a 79-year-old woman with a previously diagnosed episode of Takotsubo cardiomyopathy, who was admitted to our hospital for total hip replacement. Care was taken to provide proper preoperative sedation before provision of hyperbaric spinal anesthesia, followed by sedation with intravenous propofol. Surgery and the early postoperative period were uneventful. We believe that minimizing perioperative anxiety should be a priority in these patients due to the possibility that a catecholamine discharge might trigger an episode of Takotsubo cardiomyopathy.
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital de Navarra, Pamplona. mikelbat@arrakis.es
authors.forename: M
authors.initials: M
authors.lastname: Batllori Gastón
authors.forename: M J
authors.initials: MJ
authors.lastname: Gil Gorricho
authors.forename: N
authors.initials: N
authors.lastname: Zaballos Barcala
authors.forename: M Y
authors.initials: MY
authors.lastname: Gracia Aznárez
authors.forename: A
authors.initials: A
authors.lastname: Urchaga Litago
authors.forename: E
authors.initials: E
authors.lastname: Murillo Jason
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000368:Aged; D000771:Anesthesia, Intravenous / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology; D015897:Comorbidity; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005265:Femoral Neck Fractures / Q000523:psychology / Q000601:surgery; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D011229:Preanesthetic Medication; D015742:Propofol / Q000008:administration & dosage; D055502:Secondary Prevention; D013315:Stress, Psychological / Q000188:drug therapy* / Q000209:etiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000517:prevention & control*
chemical_list: D018686:Anesthetics, Intravenous; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol