title: Postoperative left ventricular apical ballooning: Transient Takotsubo cardiomyopathy following orthotopic liver transplantation.
abstract: METHODS
  Female, 51 FINAL DIAGNOSIS: Takotsubo cardiomyopathy Symptoms: -
  
  
  METHODS
  - Clinical Procedure: - Specialty: Cardiology • Transplantology.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  Left ventricular apical ballooning syndrome (LVAB), also known as Takotsubo cardiomyopathy, is a cardiac syndrome characterized by transient left ventricular dysfunction in the absence of obstructive atherosclerotic coronary artery disease. An episode of emotional stress, typically in female patients, is believed to precede and trigger the development of this syndrome.
  
  
  METHODS
  We report a case of Takotsubo cardiomyopathy that developed after orthotopic liver transplantation in a 51-year-old woman. On D2 (day 2) the patient had severe hemodynamic compromise. Echocardiography showed systolic dysfunction of the left ventricle (LV), with ejection fraction (EF) of 20% and anteroapical akinesis and ballooning of the apical 2/3 of the LV. Troponin T was elevated but other markers of myocardial necrosis were negative, as was coronary angiography. From D7 onward, there was an improvement in the hemodynamics in conjunction with a gradual increase of LV EF. The patient was dismissed from the hospital on D30 with signs of normal cardiac function and LV motion and EF of 50%. Liver function was also excellent.
  
  
  CONCLUSIONS
  Every major operation, including liver transplantation, is associated with emotional stress for the patient. Therefore, it is necessary to consider Takotsubo cardiomyopathy in the differential diagnosis of heart failure developing early after LT, and clinicians should subsequently use adequate diagnostic and therapeutic measures.
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.
authors.forename: Helena
authors.initials: H
authors.lastname: Bedanova
authors.forename: Marek
authors.initials: M
authors.lastname: Orban
authors.forename: Petr
authors.initials: P
authors.lastname: Nemec
keywords: cardiocenic shock; liver transplantation; takotsubo cardiomyopathy