Takotsubo cardiomyopathy triggered ventricular fibrillation one day after oral surgery in an ICD patient, which was successfully resolved by administration of amiodarone hydrochloride.
This case highlights the risk of Takotsubo cardiomyopathy and subsequent ventricular fibrillation in medically compromised patients undergoing oral surgery, emphasizing the need for careful perioperative management.
Absolute Event Rate: 0% vs 0%
Takotsubo cardiomyopathy (TCM) is characterized by contractile impairment of the left ventricular apex and excessive contraction of the base of the heart, resulting in transient cardiac dysfunction. Here, we report a case of an implantable cardioverter defibrillator (ICD) that was activated for ventricular fibrillation (VF) caused by TCM one day after removal of maxillomandibular exostoses. The patient was a 53-year-old female who underwent removal of maxillomandibular exostoses in the mid-palate area, bilateral molars of the maxilla, and bilateral mandibular premolars under general anesthesia. Because the patient had a history of VF, an ICD was implanted. Removal was performed without any problems, but VF occurred on the following day, and the ICD was frequently required. Ultrasound examination suggested contractile impairment of the ventricular apex and excessive contraction of the base. Examinations led to a diagnosis of TCM using the Mayo Clinic diagnostic criteria. VF was resolved by administration of amiodarone hydrochloride. The wound in the oral cavity healed favorably, and the patient was discharged from hospital on day 33 without further occurrence of VF. This case highlights important perioperative risk assessment and anesthesia considerations for oral and maxillofacial surgeons managing medically compromised patients undergoing oral surgery.
Shiraishi et al. (Thu,) reported a other. Takotsubo cardiomyopathy triggered ventricular fibrillation one day after oral surgery in an ICD patient, which was successfully resolved by administration of amiodarone hydrochloride.