Key result
Intraoperative endobronchial epinephrine administration induced Tako Tsubo cardiomyopathy, presenting as refractory postoperative hypotension that was rapidly diagnosed using bedside point-of-care ultrasound.
Case Report (n=1)
No
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Bedside POCUS is a crucial diagnostic tool for identifying unusual causes of postoperative hypotension, such as epinephrine-induced Takotsubo cardiomyopathy, thereby preventing inappropriate and potentially harmful fluid administration.
Background: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, apical ballooning syndrome, or “broken heart syndrome” (seen more often in women), is a condition with transient regional systolic dysfunction without angiographic evidence of obstructive coronary artery disease or acute plaque rupture. Point of Care Ultrasound (POCUS) can achieve images of cardiac function, which can often be used to interrogate possible causes of hypotension. Anesthesia teams are often required to obtain training in such modalities to be used in the perioperative setting. Case Report: The theme of the case is the unusual presentation of cardiomyopathy in the post-anesthesia care unit and the use of Point of Care Ultrasound to diagnose the cause of hypotension. Conclusion: This case illustrates why it is important to use diagnostic bedside modalities prior to generalized treatment of hypotension and how proficiency in POCUS is important.
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Hene et al. (2025) conducted a case report in Postoperative hypotension and Tako Tsubo Cardiomyopathy (n=1). Endobronchial epinephrine was evaluated on Development of Tako Tsubo cardiomyopathy. Intraoperative endobronchial epinephrine administration induced Tako Tsubo cardiomyopathy, presenting as refractory postoperative hypotension that was rapidly diagnosed using bedside point-of-care ultrasound.
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