PMC5292174_01
Preoperative TTE, end diastole (preop pics).
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Resolution of her episode of SIC was defined by a repeat echocardiogram showing EF of 60% without identifiable wall motion abnormality (Figure 1, preoperative TTE, end diastole). Six months following her initial hospital discharge, a preoperative TTE demonstrated an EF of 60-65% without wall motion abnormality and an ECG having NSR and RBBB (Figures 1-3).
Preoperative/4 months after prior takotsubo cardiomyopathy (preop pics).
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After the first hospitalization, she had a follow-up nuclear stress test with EF of 72% without wall motion abnormality and electrocardiogram (ECG) with normal sinus rhythm (NSR) and right bundle branch block (RBBB) (Figure 2, preoperative/4 months after initial SIC). Six months following her initial hospital discharge, a preoperative TTE demonstrated an EF of 60-65% without wall motion abnormality and an ECG having NSR and RBBB (Figures 1-3).
Preoperative TTE, end systole (preop pics).
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Six months following her initial hospital discharge, a preoperative TTE demonstrated an EF of 60-65% without wall motion abnormality and an ECG having NSR and RBBB (Figures 1-3).
Immediately after seizure (postop pics).
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After the first hospitalization, she had a follow-up nuclear stress test with EF of 72% without wall motion abnormality and electrocardiogram (ECG) with normal sinus rhythm (NSR) and right bundle branch block (RBBB) (Figure 2, preoperative/4 months after initial SIC). Following management of her episode of RSE, her ECG demonstrated no ST segment elevation and sinus tachycardia (Figure 4, immediately after seizure).
Mid-ventricular akinesis, end systole (postop pics).
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A formal TTE was performed the following day, which revealed posterior wall akinesia, septal wall dyskinesia, and an EF of 15-20% (Figures 5 and 6, mid-ventricular akinesis at end systole and end diastole).
Mid-ventricular akinesis, end diastole (postop pics).
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A formal TTE was performed the following day, which revealed posterior wall akinesia, septal wall dyskinesia, and an EF of 15-20% (Figures 5 and 6, mid-ventricular akinesis at end systole and end diastole).
Resolution of SIC, end systole (SIC resolution pics).
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TTE was obtained which demonstrated no wall motion abnormality and her EF returned to a baseline of 60%, which was consistent with her previous admission (Figures 7 and 8, resolution SIC, end systole and end diastole). Three weeks postoperatively, she was hypertensive and tachycardic after extubation and required labetalol to control catecholamine surge to prevent exacerbation of SIC.
Resolution of SIC, end diastole (SIC resolution pics).
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TTE was obtained which demonstrated no wall motion abnormality and her EF returned to a baseline of 60%, which was consistent with her previous admission (Figures 7 and 8, resolution SIC, end systole and end diastole). Three weeks postoperatively, she was hypertensive and tachycardic after extubation and required labetalol to control catecholamine surge to prevent exacerbation of SIC.