title: Takotsubo's syndrome after mitral valve repair and rescue with extracorporeal membrane oxygenation.
abstract: We report a case of Takotsubo's syndrome in a 37-year-old woman after mitral valve repair for severe mitral regurgitation triggered by a severe protamine reaction that was likely associated with immune-mediated coronary hypersensitivity (Kounis' syndrome) and made worse by resuscitation with high doses of catecholamines. The patient recovered fully after a 4-day course of extracorporeal membrane oxygenation therapy (ECMO).
authors.affiliation: Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Li
authors.affiliation: Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Koerner
authors.affiliation: Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Aly
authors.initials: A
authors.lastname: El-Banayosy
authors.affiliation: Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Behzad
authors.initials: B
authors.lastname: Soleimani
authors.affiliation: Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Walter E
authors.initials: WE
authors.lastname: Pae
authors.affiliation: Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: uleuenberger@hmc.psu.edu.
authors.forename: Urs A
authors.initials: UA
authors.lastname: Leuenberger
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D016638:Critical Illness; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000628:therapy; D015150:Echocardiography, Doppler / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D011479:Protamines / Q000008:administration & dosage / Q000009:adverse effects*; D018570:Risk Assessment; D012720:Severity of Illness Index; D054549:Takotsubo Cardiomyopathy / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D011479:Protamines