title: Transient cardiac failure due to Takotsubo cardiomyopathy after surgical reduction of nasal fracture.
abstract: BACKGROUND
  Takotsubo syndrome, also known as ampulla cardiomyopathy, broken heart syndrome, idiopathic apical ballooning syndrome, and stress-induced myocardial stunning, has been first described by Japanese authors in 1996 and subsequently specified in 2001; it derives from the resemblance between the ancient round-bottomed, narrow-necked Japanese fishing pots used to trap octopus in Asia and the end-systolic appearance of the left ventricle on ventriculography.
  
  
  METHODS
  We introduce the case of a woman who was involved in a traffic car crash and, subsequently, was admitted to the Maxillo-Facial Unit of the Novara Major Hospital with a diagnosis of nasal fracture. She underwent general anesthesia for the reduction of the fracture; after surgery, she developed acute chest pain, elevated cardiac biomarkers, ischemic electrocardiogram changes, and transient akinesis of the left ventricle without significant epicardial coronary artery disease. A diagnosis of takotsubo syndrome was made.
  
  
  CONCLUSIONS
  This syndrome, which presents the same clinical features of a ventricular failure, is probably underdiagnosed, but after the introduction of sophisticated cardiac imaging and coronary intervention, more cases are identified and an unnecessary thrombolytic therapy can be spared. This reversible condition, which is, to our knowledge, never mentioned after a craniomaxillofacial surgical procedure, should be considered in the diagnostic algorithm for all patients presenting with acute onset of chest pain, elevated cardiac biomarkers, and ischemic changes on the electrocardiogram after a general anesthesia.
authors.affiliation: Department of Maxillo-Facial Surgery, Azienda Ospedaliera Maggiore della Carità, University of Piemonte Orientale Amedeo Avogadro, Novara, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brucoli
authors.forename: Francesco
authors.initials: F
authors.lastname: Arcuri
authors.forename: Mariangela
authors.initials: M
authors.lastname: Giarda
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Benech
mesh_terms: D000063:Accidents, Traffic; D002637:Chest Pain / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D009295:Nasal Bone / Q000293:injuries*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy; D012887:Skull Fractures / Q000601:surgery*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000188:drug therapy