title: Acute pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman undergoing transvaginal cervical cerclage: A case report.
abstract: BACKGROUND
  The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy.
  
  
  METHODS
  We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage.
  
  
  RESULTS
  Intraoperative chest radiography revealed severe pulmonary edema and echocardiography indicated moderate left ventricular dysfunction with akinesia of the mid to apical left ventricular wall segment, which is reflective of takotsubo cardiomyopathy.
  
  
  CONCLUSIONS
  With early detection and appropriate management, the patient was stabilized in a relatively short period of time. Based on her clinical signs and symptoms, we suspect that the pulmonary edema was caused by takotsubo cardiomyopathy.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Kwon
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Yu-Mi
authors.initials: YM
authors.lastname: Lee
mesh_terms: D000328:Adult; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D023802:Cerclage, Cervical / Q000009:adverse effects / Q000379:methods; D042241:Early Diagnosis; D061345:Early Medical Intervention / Q000379:methods; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D008168:Lung / Q000000981:diagnostic imaging; D016343:Monitoring, Intraoperative / Q000379:methods; D011247:Pregnancy; D011654:Pulmonary Edema / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013902:Radiography, Thoracic / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents