Management of cesarean section in a patient with history of takotsubo cardiomyopathy-A case report

Abstract

Takotsubo cardiomyopathy (TTCM), also known as stress-induced cardiomyopathy or “broken heart syndrome,” is a clinical entity characterized by acute left ventricular dysfunction and reversible cardiac failure in the absence of coronary artery disease. Obstetric patients with a history of peripartum TTCM pose a unique challenge to the anesthesiologist. With a multiplicity of issues to be considered and no recommendations for best practice, the management plan needs to be tailored for each parturient to minimize the stress associated with labor and delivery. We present the case of an apparently healthy parturient with a history of peripartum TTCM presenting for a subsequent cesarean section and outline the various issues an anesthesiologist might encounter.