The role of the POCUS protocol in the diagnosis of urosepsis-caused Тakotsubo syndrome in a patient with cervical cancer. Clinical case report

Background. Left ventricular dysfunction often occurs in patients with sepsis. Takotsubo syndrome is an acute and usually reversible myocardial injury without the presence of an infarct-related coronary artery. However, little is known about this syndrome in patients with septic shock. Takotsubo cardiomyopathy has a similar clinical symptoms to septic myocardial dysfunction, but the two conditions have significant differences in pathogenesis, diagnosis, and treatment. Purpose – to draw the attention of intensivists to the fact that Takotsubo syndrome is often found in patients with septic shock and may be the true cause of myocardial dysfunction. Materials and Methods. This report presents a clinical case of the diagnosis and management of Takotsubo syndrome due to urosepsis in a 54-year-old woman who underwent surgery for cervical cancer. Results. As a result of the timely application of the POCUS protocol directly at the patient’s bedside, it was possible to detect the described transient dysfunction of the left ventricle in time, which radically changed the treatment tactics and saved the patient’s life. Conclusions. The first onset of hemodynamic and respiratory deterioration should raise the suspicion of Takotsubo syndrome and prompt screening for this syndrome by echocardiography in this clinical context. Therefore, mastering and applying the POCUS protocol directly at the patient’s bedside can help in solving a complex clinical situation.