Takotsubo's Cardiomyopathy in a Young Female with Severe Traumatic Brain Injury: A Case Report

IF 0.2 Q4 ANESTHESIOLOGY
Gayatri Kumari, Anoop K. Singh, Sharma V. Jaishree, Ashutosh Tiwari
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Abstract

Takotsubo's cardiomyopathy (TC) typically presents with acute cardiac dysfunction due to regional wall motion abnormality, but unlike other cardiac pathologies, it recovers within a short period. Here, we report the case of a 23-year-old woman who presented to us following severe traumatic brain injury (TBI). Her Glasgow coma scale (GCS) deteriorated rapidly in the preoperative period and she developed TC following surgery. Despite an uneventful surgery, she needed cardiovascular support by vasopressors and inotropes in the postoperative period. She was diagnosed with TC on serial transthoracic echocardiography, with complete cardiac function recovery within 9 days. The diagnosis of TC was supported by electrocardiography (not correlating coronary artery disease), elevated troponin I and N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and the presence of a physical sessor like TBI. As an unrecognized TC due to a low GCS score after severe TBI may negatively impact outcomes, we aim to emphasize that vigilant perioperative management may give good outcomes even in less commonly encountered serious TC.
严重脑外伤年轻女性的 Takotsubo 心肌病:病例报告
塔克次氏心肌病(Takotsubo's cardiomyopathy,TC)通常会因区域性室壁运动异常而出现急性心功能不全,但与其他心脏病不同的是,它能在短期内恢复。在此,我们报告了一名 23 岁女性的病例,她在严重脑外伤(TBI)后就诊。她的格拉斯哥昏迷量表(GCS)在术前迅速恶化,术后出现 TC。尽管手术顺利,但她在术后仍需要使用血管加压和肌注来支持心血管。她在连续的经胸超声心动图检查中被诊断为 TC,并在 9 天内完全恢复了心功能。心电图(与冠状动脉疾病无关联)、肌钙蛋白 I 和 N 端脑钠肽前体(NT-proBNP)升高以及类似创伤性脑损伤的体征均支持 TC 的诊断。由于严重创伤性脑损伤后因 GCS 评分较低而未被发现的 TC 可能会对预后产生负面影响,因此我们旨在强调,即使是不太常见的严重 TC,警惕的围手术期管理也可能带来良好的预后。
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来源期刊
Journal of Neuroanaesthesiology and Critical Care
Journal of Neuroanaesthesiology and Critical Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
0.50
自引率
0.00%
发文量
29
审稿时长
15 weeks
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