Yıl 2020, Cilt 11 , Sayı 39, Sayfalar 38 - 41 2020-05-19

Takotsubo Kardiyomyopatili Acil Hastada Anestezik Yaklaşım
Anesthetic Approach to Emergency Patient with Takotsubo Cardiomyopathy

Sedat HAKİMOĞLU [1] , Onur KOYUNCU [2] , Sümeyra YEŞİL [3]


Takatsubo kardiyomiyopatisi (1) (TKM), sıklıkla postmenapozal kadınlarda görülen, akut stres sonrasında katekolamin deşarjına veya koroner arter spazmına bağlı gelişen, akut myokard infarktüsüne benzer bir tablodur. TKM genellikle geri dönüşümlü sol ventrikül yetmezliği ile karakterizedir ve şüpheli akut koroner sendromların %1-3’ünü oluşturur. En sık semptomlar göğüs ağrısı, senkop, dispnedir ve anormal ST ve T (-) değişiklikleri EKG’ de sıklıkla görülür. Bu olgu sunumunda TKM’li acil sezeryan seksiyo nedeniyle operasyonuna alınmış 19 yaşında gebedeki anestezi yaklaşımımız sunulmuştur.

Takatsubo cardiomyopathy (TKM) is a table similar to the acute myocardial infarction seen in postmenopausal women, which is catecholamine discharge due to acute stress or coronary artery spasm. TKM is usually characterized by recurrent left ventricular failure and constitutes 1-3 % of suspected acute coronary syndromes. The most common symptoms are chest pain, syncope, dyspnea and abnormal ST and T (-) changes are frequently seen in ECG. In this case report, our anesthesia approach is presented in a 19-year-old pregnant with TKM who was operated on because of urgent cesarean section.

  • Sato H, Tateishi H, Dote K, Uchida T, Ishihara M. Tako-tsubo-like left ventricular dysfunction due to multivessel coronary spasm. In: Kodama K, Haze K, Hori M, editors. Clinicalaspect of myocardial injury: from ischemia to heart failure. Tokyo: Kagakuhyoronsha Publishing Co.; 1990.p.56-64.
  • Kurisu S, Kihara Y. Tako-tsubo cardiomyopathy: clinical presentation and underlying mechanism. J Cardiol 2012;60:429-37.
  • Bybee KA, Prasad A, Barsness G, Wright RS, Rihal CS. Clinical characteristics, outcomes, and impaired myocardial microcirculation in patients with transient left ventricular apical ballooning syndrome: a case-series from a U.S. medial center. Am J Cardiol. 2004;94:343–46
  • Mrdovic I, Kostic J, Perunicic J, Asanin M, Vasiljevic Z, Ostojic M. Right ventricular takotsubo cardiomyopathy. J Am Coll Cardiol 2010;55:1751.
  • Win CM, Pathak A, GuglinM. Not takotsubo: a different form of stress induced cardiomyopathy: a case series. Congest Heart Fail 2011;17:38-41
  • Kurisu S, Kihara Y. Clinical management of takotsubo cardiomyopathy. Circ J. 2014;78:1559-66.
  • Akashi YJ, Goldstein DS, Barbaro G, Ueyama T. Takotsubo cardiomyopathy: a new form of acute, reversible heart failure. Circulation. 2008;118:2754–62.
  • Elesber AA, Prasad A, Lennon RJ, Wright RS, Lerman A, Rihal CS. Four-year recurrence rate and prognosis of the apical ballooning syndrome. Journal of the American College of Cardiology 2007;50(5):448-52
  • Madhavan M, Prasad A. Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis. Herz. 2010;35:240-3.
  • Dote K, Sato H, Tateishi H, Uchida T, Ishihara M. Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases. J Cardiol 21: 203-214, 1991 (in Japanese).
  • Gültekin N, Dalgıç Y. Tako-Tsubo Kardiyomiyopatisi Tako- Tsubo Cardiomyopathy Kardiyoloji AD, İstanbul Üniversitesi Kardiyoloji Enstitüsü, İstanbul Turkiye Klinikleri J Cardiol-Special Topics 2016;9:1-7
  • Lee VH, Connolly HM, Fulgham JR, Manno EM, Brown RD Jr, Wijdicks EF. Tako-tsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage: an under appreciated ventricular dysfunction. J Neurosurg. 2006;105:264-70.
  • Singh SB, Harle IA. Takotsubo cardiomyopathy secondary in part to cancer-related pain crisis: a case report. J Pain Symptom Manage. 2014;48:137-42.
  • Küçükdurmaz Z, Karapınar H, Oflaz MB, Gül İ, Aydın G, Güneş H, et al. Takotsubo kardiyomiyopatisi hakkında klinik deneyimimiz ve ülkemizden bildirilen ilk olgu serisi Türk Kardiyol Dern Arş - Arch Turk Soc Cardiol 2013;41:212-17.
  • Deniz S, Bakal Ö, İnangil G, Şen H, Özkan S. Postoperatif Evrede Gelişen Bir Takatusubo Kardiyomiyopatisi Period Turk J Anaesth Reanim 2015; 43: 47-9.
  • Santoro F, Ieva R, Ferraretti A, Ienco V, Carpagnano G, Lodispoto M, et al. Safety and feasibility of levosimendan administration in takotsubo cardiomyopathy: A case series. Cardiovasc Ther 2013;31:133-7.
Birincil Dil tr
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Olgu Sunumu
Yazarlar

Yazar: Sedat HAKİMOĞLU (Sorumlu Yazar)
Kurum: Mustafa Kemal Üniversitesi Tıp Fakültesi,Hatay
Ülke: Turkey


Yazar: Onur KOYUNCU
Kurum: Mustafa Kemal Üniversitesi Tıp Fakültesi,Hatay
Ülke: Turkey


Yazar: Sümeyra YEŞİL
Kurum: Mustafa Kemal Üniversitesi Tıp Fakültesi,Hatay
Ülke: Turkey


Tarihler

Başvuru Tarihi : 23 Mart 2018
Kabul Tarihi : 15 Ocak 2020
Yayımlanma Tarihi : 19 Mayıs 2020

Vancouver HAKİMOĞLU S , KOYUNCU O , YEŞİL S . Takotsubo Kardiyomyopatili Acil Hastada Anestezik Yaklaşım. Mustafa Kemal Üniversitesi Tıp Dergisi. 2020; 41-38.