Thromboembolic complications in Takotsubo Syndrome during Covid-19 outbreak. A review with case report

F. Kolbakir, S. Yucel, S. B. Deşer, D. Karakaya, K. Soylu, M. Demirağ, Murat Muzafer Guclu, Merve Polat
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Abstract

New coronavirus (COVID-19) outbreak, which started in Wuhan, China and spread rapidly all over the world, has become the most important cause of the emotional distress for susceptible people. Because the people also remained in fear and anxiety during the period when the elderly population in the whole country was desperate due to the COVID-19 outbreak and was asked to stay at home in fear of death. In addition, the fact that the patients were hospitalized together with COVID-19 patients caused his psychological distress to be experienced even more. Takotsubo Syndrome (TTS) is known as a distress-induced transient left ventricular dysfunction. In our patient with TTS, it was found that a new apical thrombus, which was not seen in the left ventricle, was seen in previous echo and computerized tomographic investigation, and that it was a source of thromboemboli, by stress triggering neurocardiac reactions. While under the medical treatment of viral pneumonia, under the Coronavirus transmission measures, thrombus in the LV was removed by being taken to the emergency open heart surgery. Our case is the first patient in the literature where a new thrombus developed in the LV and splenic infarction in TTS triggered by the pandemic. In this article;We have presented the experience of TTS triggered by pandemic, etiopathogenesis of left ventricular thrombus, open heart surgery indications when COVID-19 is suspected, coronavirus transmission measures in the surgical approach, the postoperative treatment and literature is reviewed.
Covid-19暴发期间Takotsubo综合征的血栓栓塞并发症附病例报告的回顾
从中国武汉开始迅速蔓延到世界各地的新型冠状病毒(COVID-19)疫情,已成为易感人群情绪困扰的最重要原因。因为在全国老年人口因新冠肺炎疫情而陷入绝望,被要求呆在家里害怕死亡的时期,人们也一直处于恐惧和焦虑之中。此外,患者与新冠肺炎患者一起住院的事实使他的心理痛苦更加严重。Takotsubo综合征(TTS)是一种由痛苦引起的短暂性左心室功能障碍。在我们的TTS患者中,我们发现在之前的超声和计算机断层检查中发现了一个新的在左心室未见的根尖血栓,这是一个血栓栓子的来源,通过应激触发神经心脏反应。在病毒性肺炎的医学治疗下,在冠状病毒传播措施下,左室血栓被移除,被送往紧急心脏直视手术。我们的病例是文献中第一个由大流行引发的左室新血栓和TTS脾梗死的患者。本文介绍了大流行引发TTS的经验、左室血栓的发病机制、怀疑COVID-19时的心内手术指征、手术入路中的冠状病毒传播措施、术后治疗及文献综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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