title: [Perioperative approach of patient with takotsubo syndrome].
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TCM) is a stress-induced cardiomyopathy. It is characterized by an acute onset of symptoms and electrocardiographic abnormalities mimicking an acute coronary syndrome in the absence of obstructive coronary artery disease. Any anesthetic-surgical event corresponds to a stressful situation, so the anesthetic management of patients with TCM requires special care throughout the perioperative period. We describe the anesthetic management of a patient with a confirmed diagnosis of TCM undergoing segmental colectomy.
  
  
  METHODS
  Female patient, 55 years old, ASA III, with history of takotsubo syndrome diagnosed 2 years ago, scheduled for segmental colectomy. The patient, without other changes in preoperative evaluation, underwent general anesthesia associated with lumbar epidural and remained hemodynamically stable during the 2hours of surgery. After a brief stay in the Post-Anesthesia Care Unit, she was transferred to the Intermediate Care Unit (IMCU), with epidural analgesia for postoperative period.
  
  
  CONCLUSIONS
  TCM is a rare disease which true pathophysiology remains unclear, as well as the most appropriate anesthetic-surgical strategy. In this case, through a preventive approach, with close monitoring and the lowest possible stimulus, all the perioperative period was uneventful. Because it is a rare disease, this report could help to raise awareness about TCM.
authors.affiliation: Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal. Electronic address: joana.20.barros@gmail.com.
authors.forename: Joana
authors.initials: J
authors.lastname: Barros
authors.affiliation: Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal.
authors.forename: Diana
authors.initials: D
authors.lastname: Gomes
authors.affiliation: Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Caramelo
authors.affiliation: Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Pereira
mesh_terms: D000758:Anesthesia; D016888:Angiodysplasia / Q000150:complications / Q000601:surgery; D003082:Colectomy; D003108:Colonic Diseases / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D054549:Takotsubo Cardiomyopathy / Q000150:complications
keywords: Anestesia; Anesthesia; Cardiomyopathy; Estresse; Miocardiopatia; Stress; Síndrome de takotsubo; Takotsubo syndrome