title: Acute left ventricle failure on induction of anesthesia: a case report of reverse stress cardiomyopathy-presentation, diagnosis and treatment.
abstract: Reverse takotsubo cardiomyopathy (TCM) is a less common variant of classic TCM that presents within a different patient profile and with its own hemodynamic considerations. A 46-year-old woman was admitted to our hospital for laryngoscopy and possible balloon dilatation for tracheal stenosis under general anesthesia. One year prior to this admission, the patient was admitted after a motor vehicle accident with subdural hematoma, subarachnoid hemorrhage, and fracture of the eighth thoracic vertebra. She underwent uneventful anesthesia for thoracic spine surgery and tracheostomy to help her wean from the ventilator during that admission. Since her previous admission, she developed posttraumatic anxiety and depression (a neuropsychiatric disorder triggered by subdural hematoma and subarachnoid hemorrhage) and was treated with antianxiety and antidepressant medication. At this admission, the patient developed acute left ventricle failure on induction of anesthesia secondary to reverse TCM. We report a case of reverse TCM, where posttraumatic emotional stress of a neuropsychiatric disorder combined with physical stress from anesthesia and laryngoscopy triggered TCM in a patient with previous uneventful anesthesia 1 year earlier.
authors.affiliation: Department of Medicine, Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Sohail
authors.initials: S
authors.lastname: Ikram
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Louisville Hospital, 530 S. Jackson St., Louisville, KY, 40202, USA.
authors.forename: Nashwa
authors.initials: N
authors.lastname: Saleem
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Louisville Hospital, 530 S. Jackson St., Louisville, KY, 40202, USA. rklati01@louisville.edu.|Paris Simulation Center, Office of Medical Education, University of Louisville School of Medicine, Louisville, KY, USA. rklati01@louisville.edu.|Outcomes Research Consortium, Cleveland, OH, USA. rklati01@louisville.edu.
authors.forename: Rana K
authors.initials: RK
authors.lastname: Latif
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D005260:Female; D020199:Hematoma, Subdural, Acute / Q000601:surgery; D006801:Humans; D007828:Laryngoscopy; D008875:Middle Aged; D016103:Spinal Fractures / Q000601:surgery; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000209:etiology; D020206:Subarachnoid Hemorrhage, Traumatic / Q000601:surgery; D054549:Takotsubo Cardiomyopathy / Q000139:chemically induced* / Q000175:diagnosis; D014135:Tracheal Stenosis / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*
keywords: Anesthesia; Management; Neuropsychiatric disorder; Reverse stress cardiomyopathy