Key result
Preoperative emotional stress potentially caused intraoperative cardiac arrest (due to Takotsubo cardiomyopathy and a vasovagal episode) in two medically fit women undergoing radical hysterectomy.
Case Report (n=2)
Severe preoperative emotional stress can precipitate intraoperative cardiac arrest, such as Takotsubo cardiomyopathy or severe vasovagal episodes, even in young, medically fit patients.
Preoperative stress may precipitate arrest even in fit patients; hypothesis-generating for prospective stress-mitigation trials.
We report case histories of two young women who had an intraoperative cardiac arrest, potentially caused by preoperative emotional stress, while undergoing open radical hysterectomy for cervical cancer. Neither had any history of heart disease or other comorbidities. Takotsubo cardiomyopathy, a form of stress cardiomyopathy characterized by acute reversible ventricular dysfunction that can occur in the perioperative period, was the cause in one patient. A vasovagal episode during the exploration of the abdomen was the cause in the other. Successful resuscitation and stabilisation of both patients made it possible to continue the surgery and successfully complete both procedures. Takotsubo cardiomyopathy should be considered in any patient showing significant preoperative stress who has a cardiac arrest, even if there is no preoperative morbidity. It is difficult to differentiate from a vasovagal episode intraoperatively. Surgical and anaesthetic teams should be aware of importance of countering severe preoperative stress.
No takes yet. Share an insight, caveat, or question.
Schmid et al. (2021) conducted a case report in Cervical cancer (n=2). Preoperative emotional stress was evaluated on Intraoperative cardiac arrest. Preoperative emotional stress potentially caused intraoperative cardiac arrest (due to Takotsubo cardiomyopathy and a vasovagal episode) in two medically fit women undergoing radical hysterectomy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: