Resolution of Acute Respiratory Distress Syndrome-Induced Takotsubo Cardiomyopathy with Venovenous Extracorporeal Membrane Oxygenation

Fig. 1. Intraoperative transesophageal echocardiography imaging of a mid-esophageal modified 5-chamber view (A), transgastric basal short-axis view, (C), transgastric mid-chamber short-axis view (D), and transgastric apical short-axis view (E). Left ventricular ejection fraction calculated at 14% via 3-D volumetrics (B). The images show basal contractility (C) with mid-chamber (D) and apical hypokinesis (E), consistent with Takotsubo/stress-induced cardiomyopathy. Post veno-venous extracorporeal membrane oxygenation on day 1 shows resolution of regional wall motion abnormalities in transthoracic apical 2-chamber view in Mayo Clinic format with the left ventricle on the left side of the screen (F).

Fig. 2. Intraoperative transesophageal echocardiography imaging of a transgastric mid-chamber short-axis view (A), and transgastric apical short-axis view (B). The images show severe mid-chamber akinesis (A) and apical hypokinesis (B), consistent with a reverse Takotsubo/stress-induced cardiomyopathy pattern. Post veno-venous extracorporeal membrane oxygenation on day 1 shows resolution of regional wall motion abnormalities in transthoracic modified apical 4-chamber view in Mayo Clinic format with the left ventricle on the left side of the screen (C) and a calculated 2-D biplane volumetric left ventricular ejection fraction of 59% per report.