title: Takotsubo cardiomyopathy after cesarean section: A case report and literature review.
abstract: Takotsubo cardiomyopathy (TCM) is clinically identical to acute myocardial infarction. We report an unusual case of TCM and review similar cases in pregnant women. A young woman with no pre-existing cardiovascular risk factors suffered sudden dyspnea during a cesarean section. Electrocardiography (ECG) showed T-wave inversion. We observed acute lung edema and left ventricular systolic dysfunction on echocardiography. A cardiac catheterization diagnosed TCM. We reviewed 20 cases of TCM; 17 cases occurred during the post-partum period and three during pregnancy. Five of these cases had vaginal deliveries and the remaining cases had cesarean sections. Within the latter group, five cases appeared intraoperatively. With the exception of one patient with normal ECG results, all other patients progressed, with changes in ECG readings and elevation of cardiac enzyme serum levels. However, cardiac catheterization revealed that coronary arterial damage did not occur in any of the cases. After three months, each patient fully recovered.
authors.affiliation: Department of Obstetrics, Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Ruiz
authors.affiliation: Department of Cardiology, Clinic Universitary Hospital Lozano Blesa, Zaragoza, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Martinez-Marin
authors.affiliation: Department of Intensive Care Unit, Clinic Universitary Hospital Lozano Blesa, Zaragoza, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Luque
authors.affiliation: Department of Obstetrics, Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.
authors.forename: Nadia
authors.initials: N
authors.lastname: Nassar
authors.affiliation: Department of Obstetrics, Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Oros
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging*; D011247:Pregnancy; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging*
keywords: Cesarean section; cardiovascular; critical care obstetrics; obstetric anesthesia; post dates