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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-41194

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.

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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.


12 citations in Web of Science®
14 citations in Scopus®
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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
Deposited On:07 Jan 2011 09:57
Last Modified:28 Nov 2013 00:08
Publisher DOI:10.1007/s00404-010-1769-6
PubMed ID:21136269

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