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"Broken heart" after cesarean delivery. Case report and review of literature


Zdanowicz, J A; Utz, A C; Geier, S; Corti, R; Beinder, E (2011). "Broken heart" after cesarean delivery. Case report and review of literature. Archives of Gynecology and Obstetrics, 283(4):687-694.

Abstract

Objective To present a rare case of a multiparous woman
undergoing elective cesarean section with apparent symptoms
of acute coronary syndrome and who was later
diagnosed with Takotsubo cardiomyopathy (TCM; ‘‘broken
heart syndrome’’). To review similar case reports
already reported in literature.
Methods Literature search on the occurrence of TCM in
pregnancy using MEDLINE and Cochrane databases.
Results TCM might occur in women with no known preexisting
cardiomyopathy and uncomplicated pregnancies
undergoing cesarean section, especially in combination
with the administration of catecholamines/vasoconstrictive
substances and possibly also oxytocin and prostaglandins.
Conclusions Since TCM is related to emotional and
physical stress, the surroundings during cesarean section
should be kept quiet and smooth. Adrenergic stimulants
(adrenaline, phenylephrine, ergonovine, ephedrine) and
anticholinergics (atropine) should be used with caution and
adequate volume substitution prior to the onset of spinal
analgesia for the prevention of hypotension should be
provided. If signs of an acute coronary syndrome during
cesarean section do occur, echocardiography is obligatory
for diagnosis of TCM.

Objective To present a rare case of a multiparous woman
undergoing elective cesarean section with apparent symptoms
of acute coronary syndrome and who was later
diagnosed with Takotsubo cardiomyopathy (TCM; ‘‘broken
heart syndrome’’). To review similar case reports
already reported in literature.
Methods Literature search on the occurrence of TCM in
pregnancy using MEDLINE and Cochrane databases.
Results TCM might occur in women with no known preexisting
cardiomyopathy and uncomplicated pregnancies
undergoing cesarean section, especially in combination
with the administration of catecholamines/vasoconstrictive
substances and possibly also oxytocin and prostaglandins.
Conclusions Since TCM is related to emotional and
physical stress, the surroundings during cesarean section
should be kept quiet and smooth. Adrenergic stimulants
(adrenaline, phenylephrine, ergonovine, ephedrine) and
anticholinergics (atropine) should be used with caution and
adequate volume substitution prior to the onset of spinal
analgesia for the prevention of hypotension should be
provided. If signs of an acute coronary syndrome during
cesarean section do occur, echocardiography is obligatory
for diagnosis of TCM.

Citations

14 citations in Web of Science®
15 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:07 Jan 2011 09:57
Last Modified:05 Apr 2016 14:31
Publisher:Springer
ISSN:0932-0067
Publisher DOI:10.1007/s00404-010-1769-6
PubMed ID:21136269
Permanent URL: http://doi.org/10.5167/uzh-41194

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