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Perioperative management of Takotsubo cardiomyopathy: an overview.
Pillitteri, Marta; Brogi, Etrusca; Piagnani, Chiara; Bozzetti, Giuseppe; Forfori, Francesco.
Afiliación
  • Pillitteri M; Department of Anaesthesia and Intensive Care, University of Pisa, Pisa, Italy.
  • Brogi E; Neuroscience Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy. etrusca.brogi@ospedaleniguarda.it.
  • Piagnani C; Department of Anaesthesia and Intensive Care, University of Pisa, Pisa, Italy.
  • Bozzetti G; Department of Anaesthesia, Peri Operative Medicine and Critical Care, NHS Golden Jubilee, Glasgow, UK.
  • Forfori F; Department of Anaesthesia and Intensive Care, University of Pisa, Pisa, Italy.
J Anesth Analg Crit Care ; 4(1): 45, 2024 Jul 15.
Article en En | MEDLINE | ID: mdl-39010210
ABSTRACT
Resembling the morphology of Japanese polyp vessels, the classic form of Takotsubo cardiomyopathy is characterized by the presence of systolic dysfunction of the mid-apical portion of the left ventricle associated with basal hyperkinesia. It is believed that this may be due to a higher density of ß-adrenergic receptors in the context of the apical myocardium, which could explain the greater sensitivity of the apex to fluctuations in catecholamine levels.The syndrome is precipitated by significant emotional stress or acute severe pathologies, and it is increasingly diagnosed during the perioperative period. Indeed, surgery, induction of general anaesthesia and critical illness represent potential harmful trigger of stress cardiomyopathy. No universally accepted guidelines are currently available, and, generally, the treatment of TTS relies on health care personal experience and/or local practice. In our daily practice, anaesthesiologists can be asked to manage patients with the diagnosis of new-onset Takotsubo before elective surgery or an emergent surgery in a patient with a concomitant stress cardiomyopathy. Even more, stress cardiomyopathy can arise as a complication during the operation.In this paper, we aim to provide an overview of Takotsubo syndrome and to discuss how to manage Takotsubo during surgery and in anaesthesiologic special settings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Anesth Analg Crit Care Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Anesth Analg Crit Care Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido