Stress-Induced Cardiomyopathy (Takotsubo Cardiomyopathy) After Liver Transplantation—Report of Two Cases

Abstract Cardiac complications after liver transplantation are a common cause of death. Stress-induced cardiomyopathy, also called takotsubo cardiomyopathy, is a special form of cardiomyopathy that is precipitated by a stress situation. It can occur after a surgical procedure that results in acute h...

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Bibliographic Details
Published in:	Transplantation proceedings Vol. 44; no. 8; pp. 2497 - 2500
Main Authors:	Tachotti Pires, L.J, Cardoso Curiati, M.N, Vissoci Reiche, F, Silvestre, O.M, Mangini, S, Carballo Afonso, R, Ferraz-Neto, B.-H, Bacal, F
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Amsterdam Elsevier Inc 01-10-2012 Elsevier
Subjects:	Adult Biological and medical sciences Fatal Outcome Female Fundamental and applied biological sciences. Psychology Fundamental immunology Heart Arrest - etiology Heart Failure - etiology Hemodynamics Humans Liver Transplantation - adverse effects Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Recovery of Function Shock, Cardiogenic - etiology Stroke Volume Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Takotsubo Cardiomyopathy - diagnostic imaging Takotsubo Cardiomyopathy - etiology Takotsubo Cardiomyopathy - physiopathology Takotsubo Cardiomyopathy - therapy Tissue, organ and graft immunology Treatment Outcome Ultrasonography Ventricular Function, Left Case study Medicine Treatment Digestive system Surgery Liver Cardiovascular disease Graft Transient left ventricular apical ballooning Stress cardiomyopathy Homotransplantation Liver transplantation
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Summary:	Abstract Cardiac complications after liver transplantation are a common cause of death. Stress-induced cardiomyopathy, also called takotsubo cardiomyopathy, is a special form of cardiomyopathy that is precipitated by a stress situation. It can occur after a surgical procedure that results in acute heart failure. Herein we have presented 2 cases of reversible stress-induced cardiac dysfunction early in the period after liver transplantation. Before surgery, cardiac evaluation was normal, with both patients classified as low risk for cardiovascular events during the proposed procedure. Both patients experienced cardiac arrest after graft reperfusion with return of spontaneous circulation after resuscitation. Their early periods after transplantation were characterized by cardiogenic shock secondary to important ventricular dysfunction requiring vasoactive drugs. Subsequent investigations excluded coronary disease. The diagnosis of takotsubo cardiomyopathy was established based on the clinical features and ancillary tests, particularly echocardiography showing apical ballooning. In both cases, ventricular function recovered completely. In conclusion, stress-induced cardiomyopathy, an underestimated cause of heart complications, should be considered as a possible cause of cardiac failure in liver transplant patients.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0041-1345 1873-2623
DOI:	10.1016/j.transproceed.2012.07.037