Stress Cardiomyopathy Associated with Anesthesia

Takotsubo cardiomyopathy is one of the acquired cardiomyopathies which occurs due to physical or emotional stress. Its most common manifestations are chest pain, dyspnea but may be accompanied with myalgia, abdominal symptoms, palpitations syncope or presyncope. These symptoms can vary from mild to severe forms. It mimics myocardial infarction as greater than 80% of patients with takotsubo cardiomyopathy have ST segment elevation on electrocardiogram, followed by diffuse deep T-wave inversion and QT prolongation. Ventriculography often shows transient hypo kinesis of left ventricular apex but cardiac catheterization shows no coronary artery disease and it resolves completely within days to weeks. Electrocardiographic and echocardiographic disturbances are seen with reduced LVEF and normal angiography. In this report, we present a case of 67 years old lady who was scheduled for right breast lumpectomy and underwent stress cardiomyopathy due to anesthesia effects. Case description will further illustrate the patient, procedure and anesthetic management.