title: Reverse Takotsubo Cardiomyopathy following Inadvertent Intrathecal Injection during Percutaneous Epidural Neuroplasty.
abstract: Stress induced cardiomyopathy (SIC) is becoming increasingly described as an underdiagnosed complication during common medical procedures. Reverse Takotsubo cardiomyopathy (RTC) is a variant of SIC that involves the basal and mid-ventricular segments and spares the apical segments. The authors present a rare case of RTC, following an inadvertent intrathecal injection during percutaneous epidural neuroplasty. Although the precise mechanism involved remains unclear, the direct neurohumoral effects of the hyperbaric anaesthetics and adhesiolytics appear to have resulted in a catecholamine surge and myocardial stunning that precipitated the SIC.
authors.affiliation: Division of Cardiology, Yeungnam University Medical Center, Daegu, South Korea.
authors.forename: Chan-Hee
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Yeungnam University Medical Center, Daegu, South Korea.
authors.forename: Jang-Won
authors.initials: JW
authors.lastname: Son
authors.affiliation: Division of Cardiology, Yeungnam University Medical Center, Daegu, South Korea. Electronic address: woongwa@hanmail.net.
authors.forename: Ung
authors.initials: U
authors.lastname: Kim
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects*; D054549:Takotsubo Cardiomyopathy / Q000209:etiology* / Q000628:therapy*
keywords: Anesthaesia; Catecholamine; Intrathecal injection; Myocardial stunning; Stress cardiomyopathy; Takotsubo