Tako-Tsubo cardiomyopathy caused immediately following cesarean section delivery of triplets: a case report.
The name 'tako-tsubo' cardiomyopathy was initially used to describe a unique 'short-neck round-flask'-shaped form of left ventricular apical ballooning, resembling a Japanese tako-tsubo, a jar (tsubo) used for capturing octopus (tako). Tako-tsubo cardiomyopathy exhibits acute onset, transient left ventricular apical wall motion abnormalities with chest symptoms and minimal myocardial enzymatic release, mimicking acute myocardial infarction in patients without angiographic stenosis on coronary angiography. There have been few case reports on tako-tsubo cardiomyopathy, and this disorder is especially rare in pregnant women. A 30-year-old woman who was pregnant with triplets, and had been treated with ritodrine hydrochloride for 12 weeks for threatened premature delivery, underwent cesarean section with spinal anesthesia at 30 weeks' gestation. Three hours later, she complained of acute chest pain, dyspnea and episodes of unconsciousness. She was transferred to the intensive care unit and intubated for ventilatory support. We diagnosed heart failure due to tako-tsubo cardiomyopathy based on heart ultrasonography, blood tests, chest X-ray, electrocardiogram and myocardial scintigraphy. She was extubated from the ventilator after 3 days of catecholamine, furosemide and carperitide administration. She was discharged from the hospital on day 53 without symptoms.
Department of Obstetrics and Gynecology, Center for Maternal Fetal Intensive Care Unit, Iwate Medical University School of Medicine, Morioka, Japan. tshoji@iwate-med.ac.jp
Tadahiro
T
Shoji
Eriko
E
Takatori
Rie
R
Oyama
Seisuke
S
Kumagai
Akimune
A
Fukushima
Akira
A
Yoshizaki
Toru
T
Sugiyama
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000627:therapeutic use; D002395:Catecholamines / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects*; D002637:Chest Pain / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000188:drug therapy; D012121:Respiration, Artificial; D012312:Ritodrine / Q000627:therapeutic use; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D015149:Tocolytic Agents / Q000627:therapeutic use; D014310:Triplets
D002395:Catecholamines; C472955:NPPA protein, human; D049994:Sodium Potassium Chloride Symporter Inhibitors; D015149:Tocolytic Agents; D005665:Furosemide; D009320:Atrial Natriuretic Factor; D012312:Ritodrine