Takotsubo Cardiomyopathy After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for a Recurrent Colon Cancer: A Life-Threatening Complication

(1) Background: Takotsubo cardiomyopathy, or stress cardiomyopathy, is an acute heart failure condition with transient left ventricular (LV) motion abnormalities but no significant coronary artery obstruction. It mimics acute coronary syndrome (ACS), with symptoms like chest pain, dyspnea, and ECG c...

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Bibliographic Details
Published in:Diagnostics (Basel) 2024-10, Vol.14 (21), p.2402
Main Authors: Moldovan, Bogdan, Adam, Iris-Iuliana, Pisică, Radu-Mihai, Untaru, Vlad, Stoica, Doly, Șpac, Alexandra, Modrigan, Irina, Ursu, Mihai, Jupoiu, Liliana, Frâncu, Adina, Pescaru, Florentina, Hubeishie, Amir, Zolog, Adriana, Vecerzan, Liliana
Format: Article
Language:English
Subjects:
Abdomen
Acute coronary syndromes
acute heart failure
Akinesia
Antiarrhythmics
Beta blockers
Biomarkers
Cancer
Cardiac patients
Cardiomyopathy
Case Report
Case reports
Catecholamines
Chemotherapy
Colon cancer
Colorectal cancer
Cytokines
cytoreductive surgery (CRS)
Diseases
Heart
Heart diseases
Hemodynamics
hyperthermic intraperitoneal chemotherapy (HIPEC)
Krukenberg tumor
Medical imaging
Metastasis
Ovaries
Patients
Peritoneal cancer
Relapse
Remission (Medicine)
stress cardiomyopathy
Surgery
Takotsubo cardiomyopathy
Tumors
Ultrasonic imaging
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Summary:(1) Background: Takotsubo cardiomyopathy, or stress cardiomyopathy, is an acute heart failure condition with transient left ventricular (LV) motion abnormalities but no significant coronary artery obstruction. It mimics acute coronary syndrome (ACS), with symptoms like chest pain, dyspnea, and ECG changes. (2) Case Report: We present the case of a 44-year-old female with relapsed colon cancer and peritoneal carcinomatosis. After undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), she experienced cardiac arrest from ventricular fibrillation 18 h postoperatively. Echocardiography revealed a reduced LV ejection fraction (20%) and apical akinesia, suggesting a Takotsubo Cardiomyopathy. Intensive resuscitation and inotropic support led to gradual recovery. Coronary angiography confirmed no coronary artery obstruction. (3) Discussion: This case highlights TTS as a rare but severe complication following major oncological surgeries, possibly triggered by both physical and emotional stressors. TTS should be considered in the differential diagnosis of perioperative cardiac events in cancer patients. (4) Conclusions: Prompt recognition and management of TTS in the perioperative period are crucial to improving outcomes, especially in high-risk oncological patients undergoing extensive surgeries.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14212402