Stress cardiomyopathy following pericardectomy in a child: A case report

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Takotsubo (stress) cardiomyopathy following radical pericardectomy for tuberculous pericardial effusion (n=1). Intervention: Radical pericardectomy and multi-agent inotropic/vasopressor supportive therapy. Primary outcome: Left ventricular ejection fraction (LVEF) recovery.

Rajat Kalra

doi:10.6026/973206300226263

October 31, 2026BioinformationOpen Access

Stress cardiomyopathy following pericardectomy in a child: A case report

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Key result

Pediatric pericardectomy triggers reversible stress cardiomyopathy, with LVEF recovering to ~58% on supportive care.

n=1

Why the study?

Takotsubo cardiomyopathy is an acute reversible cause of transient left ventricular dysfunction that is a diagnosis of exclusion and exceptionally rare in the paediatric post-operative setting.

Key Points

To report a rare pediatric case of acute, reversible stress cardiomyopathy occurring after radical pericardectomy for tuberculous pericardial effusion.
Clinical evaluation and management of a 10-year-old male presenting with cardiac tamponade secondary to tuberculous pericardial effusion who underwent radical pericardectomy.
Diagnostic workup included serial echocardiography, coronary assessment, cardiac biomarker measurement, and application of InterTAK Diagnostic Criteria to exclude alternative causes.
Refractory hypotension and severe left ventricular dysfunction developed within 24 hours of surgery, reaching a nadir LVEF of 20% that required multi-agent inotropic support.
Diagnostic testing showed characteristic apical ballooning, mild troponin elevation, and normal coronary anatomy, with complete ventricular recovery achieved following supportive management.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

1 10-year-old male child in India with tuberculous pericardial effusion and tamponade who developed stress cardiomyopathy after radical pericardectomy, followed for 6 weeks.

E

Exposure

Radical pericardectomy and complete debridement via median sternotomy, followed by post-operative supportive management in the paediatric intensive care unit including mechanical ventilation, fluid restriction, electrolyte management, prophylactic anticoagulation, anti-tubercular therapy, and escalated inotropic/vasopressor support over 72 hours (dopamine up to 20 μg/kg/min, dobutamine 20 μg/kg/min, adrenaline 0.2 μg/kg/min, and noradrenaline 0.2 μg/kg/min).

O

Outcome

Recovery of left ventricular ejection fraction (LVEF) and haemodynamic stabilitysurrogate

This case report highlights that severe paediatric stress cardiomyopathy can be triggered by radical pericardectomy for tuberculous pericardial tamponade, and that complete ventricular recovery (from LVEF 20% to 58% in 10 days) is achievable with early recognition and supportive care.

Limitations

Single patient case report representing a case-level contribution rather than proof of an unprecedented mechanism
The InterTAK Diagnostic Criteria used for diagnosis are not specifically validated in children
No universally accepted treatment guideline currently exists for pediatric stress cardiomyopathy
InterTAK Diagnostic Criteria are not specifically validated in children
Single patient case report representing a case-level contribution rather than proof of an entirely unprecedented mechanism

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Implication

Stress cardiomyopathy may follow pericardiectomy in children; extends adult observations but remains hypothesis-generating.

Abstract

Takotsubo (stress) cardiomyopathy is an acute reversible cause of transient left ventricular dysfunction. It is a diagnosis of exclusion and is exceptionally rare in the paediatric post-operative setting. We report a 10-year-old male who developed refractory hypotension and severe left ventricular dysfunction. This occurred within 24 hours of radical pericardectomy for tuberculous pericardial effusion. Thus, data shows the importance of early recognition of stress cardiomyopathy in unexplained post-operative ventricular dysfunction.

Discussion

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Cite This Study

Rajat Kalra (2026) conducted a case report in Takotsubo (stress) cardiomyopathy following radical pericardectomy for tuberculous pericardial effusion (n=1). Radical pericardectomy and multi-agent inotropic/vasopressor supportive therapy was evaluated on Left ventricular ejection fraction (LVEF) recovery. Radical pericardectomy for tuberculous pericardial effusion triggered stress cardiomyopathy in a 10-year-old boy (nadir LVEF 20% at 24h), with full LVEF recovery to 58% by day 10 on supportive care.

synapsesocial.com/papers/6aebc8cf3e63ca1b6c315eef https://doi.org/10.6026/973206300226263

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Stress cardiomyopathy following pericardectomy in a child: A case report

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Stress cardiomyopathy following pericardectomy in a child: A case report

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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