Extracorporeal cardiopulmonary resuscitation for Takotsubo cardiomyopathy triggered by coronary vasospasm complicated with gastrointestinal bleeding: A case report

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  Fig. 1. a. Multiple ulcers in the gastric antrum and duodenal bulb. b. Sinus rhythm with ST-segment depression in leads V1-V4. c-f. Severe spasm observed in both the left and right coronary arteries. g-j. Chronic occlusion in the mid-distal LCx with collateral circulation following nitroglycerin administration; mild stenosis in the LAD. k. No cerebral edema was observed after cardiac arrest. l. No cerebral edema was observed on day 4. m-n. Left ventricular dysfunction and wall motion abnormalities with ballooning, resembling the shape of an octopus trap.

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  Fig. 2. a. cTnT level increased to >10.000 ng/mL and remained elevated beyond the measurable range on day 9; b. creatine kinase MB level increased to >3000.00 ng/mL; c. myoglobin level increased to >3000.00 ng/mL; d. NT-proBNP level increased to 20969 pg/mL; e. hemoglobin level decreased to 53 g/L post-cardiac arrest, gradually increasing and stabilizing with blood transfusion; f. GCS score gradually improved from 3 to 11, and increased to 14 on the discharge day; g. aPTT level normalized with blood transfusion and remained stable without anticoagulant strategy.