Takotsubo Syndrome After Cardiopulmonary Resuscitation During Emergency Cesarean Delivery.
Takotsubo syndrome is a rare, stress-related, and reversible form of acute heart failure primarily affecting postmenopausal women. It is characterized by left ventricular dysfunction with a classic apical and midventricular wall motion abnormality (apical ballooning).



A 28-year-old woman, gravida 2 para 1, at 30 4/7 weeks of gestation was admitted with fetal bradycardia, a fully dilated cervix, and breech presentation. During emergency cesarean delivery, the patient had intraoperative cardiac arrest. Resuscitation was successful. Twelve hours postoperatively, after demonstrating symptoms of acute heart failure, she was diagnosed with Takotsubo syndrome.



Peripartum Takotsubo syndrome must be differentiated from peripartum cardiomyopathy. Cesarean delivery and sympathomimetic medications can increase the risk of occurrence. Early recognition and interdisciplinary management are essential in the prevention of serious and potentially fatal complications.
Departments of Obstetrics and Gynecology and Cardiology, Klinikum Kempten Oberallgäu, Kempten, Germany.
Katrina
K
Kraft
Matthias
M
Graf
Martin
M
Karch
Ricardo
R
Felberbaum
D000328:Adult; D016887:Cardiopulmonary Resuscitation; D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D005316:Fetal Distress / Q000601:surgery; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology