Takotsubo Cardiomyopathy following Eye Surgery under Local Anesthesia – A Case Report

Abstract

Takotsubo syndrome is extremely rare and usually seen in postmenopausal women. It manifests as acute coronary syndromes (ACS), but coronaries are usually normal and the majority recover completely without residual myocardial damage. We are reporting one such case, which followed laser therapy for glaucoma under local anesthesia. She fulfilled all the revised Mayo Clinic criteria for diagnosis. Her preoperative cardiac evaluation and computerized tomography coronary angiograms were normal. This report highlights the need for a wide index of suspicion in those presenting as ACS. Surgical procedures however minor they are, even under local anesthesia should not be considered no-risk ones. Takotsubo cardiomyopathy is reversible acute cardiomyopathy that can occur even after minor eye surgery under local anesthesia. Patients may need coronary angiogram and serial echocardiogram at follow-up. It can be prevented by avoiding trigger factors, addressing preexisting neuropsychiatric ailments, and institution of prophylactic beta-blocker therapy.