Reverse takotsubo cardiomyopathy induced by adrenaline-containing irrigation solution during shoulder arthroscopy*

IF 0.8 Q3 ANESTHESIOLOGY
K. Azem, O. Kaplan, B. Zribi, J. Elliston, E. Mangoubi, K. Orvin, S. Fein
{"title":"Reverse takotsubo cardiomyopathy induced by adrenaline-containing irrigation solution during shoulder arthroscopy*","authors":"K. Azem,&nbsp;O. Kaplan,&nbsp;B. Zribi,&nbsp;J. Elliston,&nbsp;E. Mangoubi,&nbsp;K. Orvin,&nbsp;S. Fein","doi":"10.1002/anr3.12235","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>Takotsubo cardiomyopathy is characterised by reversible systolic dysfunction resulting from catecholamine-induced vasospasm, mainly triggered by intense emotional or physical stress. Adding adrenaline to arthroscopic irrigation solution enhances visibility by minimising bleeding. However, there is a risk of complications due to systemic absorption. Several severe cardiac consequences have been described. Here, we present a case of a patient who underwent elective shoulder arthroscopy involving an adrenaline-containing irrigation solution. Forty-five minutes after surgery began, he developed ventricular arrhythmias with hemodynamic instability, necessitating vasopressor support. Bedside transthoracic echocardiography revealed severe left ventricular dysfunction with basal ballooning, and emergent coronary angiography revealed normal coronary arteries. These findings correspond to a reverse variant of takotsubo cardiomyopathy. The patient was transferred to the intensive cardiac care unit sedated, ventilated and hemodynamically supported. Three days following the procedure, he was successfully weaned from vasopressors and mechanical ventilation. Transthoracic echocardiography 3 months after surgery demonstrated complete left ventricular function recovery. Although complications due to adrenaline-containing irrigation solutions are rare, a growing body of case reports should prompt consideration of the safety of this practice.</p>\n </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1002/anr3.12235","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/anr3.12235","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Takotsubo cardiomyopathy is characterised by reversible systolic dysfunction resulting from catecholamine-induced vasospasm, mainly triggered by intense emotional or physical stress. Adding adrenaline to arthroscopic irrigation solution enhances visibility by minimising bleeding. However, there is a risk of complications due to systemic absorption. Several severe cardiac consequences have been described. Here, we present a case of a patient who underwent elective shoulder arthroscopy involving an adrenaline-containing irrigation solution. Forty-five minutes after surgery began, he developed ventricular arrhythmias with hemodynamic instability, necessitating vasopressor support. Bedside transthoracic echocardiography revealed severe left ventricular dysfunction with basal ballooning, and emergent coronary angiography revealed normal coronary arteries. These findings correspond to a reverse variant of takotsubo cardiomyopathy. The patient was transferred to the intensive cardiac care unit sedated, ventilated and hemodynamically supported. Three days following the procedure, he was successfully weaned from vasopressors and mechanical ventilation. Transthoracic echocardiography 3 months after surgery demonstrated complete left ventricular function recovery. Although complications due to adrenaline-containing irrigation solutions are rare, a growing body of case reports should prompt consideration of the safety of this practice.

肩关节镜术中含肾上腺素冲洗液致逆行takotsubo心肌病*
Takotsubo心肌病的特点是儿茶酚胺诱导的血管痉挛引起的可逆性收缩功能障碍,主要由强烈的情绪或身体压力引发。在关节镜冲洗液中添加肾上腺素可以最大限度地减少出血,从而提高能见度。然而,由于全身吸收存在并发症的风险。已经描述了几种严重的心脏后果。在这里,我们介绍了一例患者,他接受了选择性肩关节镜检查,包括含有肾上腺素的冲洗溶液。手术开始45分钟后,他出现室性心律失常,血流动力学不稳定,需要血管升压药支持。床边经胸超声心动图显示严重的左心室功能障碍伴基底球囊扩张,急诊冠状动脉造影显示冠状动脉正常。这些发现对应于takotsubo心肌病的反向变体。患者被转移到心脏重症监护室,进行镇静、通气和血液动力学支持。手术后三天,他成功地脱离了血管升压药和机械通气。经胸超声心动图3 术后数月左心室功能完全恢复。尽管含有肾上腺素的冲洗溶液引起的并发症很少见,但越来越多的病例报告应该促使人们考虑这种做法的安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.30
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信