Takotsubo Syndrome After Cardiopulmonary Resuscitation During Emergency Cesarean Delivery

Obstet Gynecol. 2017 Mar;129(3):521-524. doi: 10.1097/AOG.0000000000001850.

Abstract

Background: 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).

Case: 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.

Conclusion: 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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cardiopulmonary Resuscitation
  • Cesarean Section
  • Emergencies
  • Female
  • Fetal Distress / surgery
  • Heart Arrest* / therapy
  • Humans
  • Intraoperative Complications* / therapy
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis*
  • Pregnancy Complications, Cardiovascular / therapy
  • Takotsubo Cardiomyopathy / diagnosis*
  • Takotsubo Cardiomyopathy / physiopathology
  • Ventricular Dysfunction, Left / physiopathology