Key result
Severe stress cardiomyopathy complicated by cardiogenic shock following spinal corrective surgery in a 16-year-old female was successfully managed with VA-ECMO and multidisciplinary supportive care.
Why the study?
Stress cardiomyopathy is an acute heart failure syndrome that has rarely been reported in patients undergoing spinal surgery.
Case Report (n=1)
No
Severe stress cardiomyopathy can occur following spinal corrective surgery in patients with scoliosis and pectus excavatum, and early recognition combined with mechanical circulatory support like VA-ECMO can lead to full recovery.
May support VA-ECMO in severe post-operative stress cardiomyopathy; single case leaves open need for prospective validation.
BACKGROUND: Stress cardiomyopathy (SCM) is an acute heart failure syndrome characterized by transient, usually reversible left ventricular systolic dysfunction with normal or enhanced basal compensatory wall motion abnormalities involving the left ventricular anterior septum and apex, resulting in a "ballooning" appearance. However, it has rarely been reported in patients undergoing spinal surgery. CASE PRESENTATION: We report a case of severe stress cardiomyopathy in a scoliosis patient with pectus excavatum who underwent spinal corrective surgery. During the wake-up period, circulatory collapse occurred. After multidisciplinary consultation, the patient was diagnosed with stress cardiomyopathy. At last, she had a good prognosis after a series of treatments including ECMO. CONCLUSION: Stress cardiomyopathy is a reversible but uncommon condition. It can cause death if it is not diagnosed in time. Consequently, this report should improve the awareness of orthopedists and anesthesiologists for timely identification and management. For patients with potential risk factors, timely preoperative intervention should be performed to reduce the occurrence of stress cardiomyopathy.
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Yan et al. (2024) conducted a case report in Stress cardiomyopathy (n=1). Veno-arterial extra-corporeal membrane oxygenation (VA-ECMO) and supportive care was evaluated on Clinical recovery and cardiac function improvement. Severe stress cardiomyopathy complicated by cardiogenic shock following spinal corrective surgery in a 16-year-old female was successfully managed with VA-ECMO and multidisciplinary supportive care.
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