title: Takotsubo cardiomyopathy associated with pulmonary resections after induction chemoradiotherapy for non-small cell lung cancer.
abstract: Takotsubo cardiomyopathy (TTC), also known as transient left ventricular (LV) apical ballooning syndrome, is characterized by transient LV dysfunction. We present the case of a 72-year-old man who was diagnosed as having TTC after surgery for two lung tumors. The patient was treated with induction chemoradiotherapy (CRT) followed by pulmonary resections for double primary non-small cell lung cancers (NSCLC): cT4N1M0 disease in the right lung and cT2N0M0 in the left lung. Induction CRT was performed. A right upper lobectomy was initially performed, and a left upper divisionectomy was subsequently performed. At 3 days after the second surgery, he developed dyspnea and general fatigue accompanied by a T-wave inversion on electrocardiography (ECG). An echocardiogram revealed akinesis at the apex with a 30 % ejection fraction. He was diagnosed as having TTC and recovered with supportive care. This case is the first report of TTC occurring after tri-modality therapy for NSCLC.
authors.affiliation: Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan. toyooka@md.okayama-u.ac.jp
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Akagi
authors.forename: Masashi
authors.initials: M
authors.lastname: Furukawa
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Junichi
authors.initials: J
authors.lastname: Soh
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamane
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oto
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D020360:Neoadjuvant Therapy; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011013:Pneumonectomy / Q000009:adverse effects*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome