A case of stress induced cardiomyopathy with extracorporeal membrane oxygenation after total colectomy

Sanjay Madhukar Surwade, Tapas Mandal, Hemant Mehta, Shaunak Mangeshkar


Takotsubo cardiomyopathy or stress-induced cardiomyopathy is a cardiac syndrome of a reversible, transient left ventricular dysfunction that is caused by emotional and/or physical stress and surgery. Its clinical manifestations are similar to acute myocardial ischemia in absence of coronary artery lesion. It is more common in middle-aged women, and the prognosis is favourable. We report the case of a 32-year-old male patient who underwent a total colectomy, developed stress-induced cardiomyopathy and had poor outcome despite extracorporeal membrane oxygenation (ECMO).


Cardiomyopathy, Extracorporeal membrane oxygenation, General anesthesia, Stress

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Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J. 2008 Mar 1;155(3):408-17.

Gianni M, Dentali F, Grandi AM, Sumner G, Hiralal R, Lonn E. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J. 2006 May 23;27(13):1523-9.

Dote K, Sato H, Tateishi H, Uchida T, Ishihara M. Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases. J Cardiol. 1991;21(2):203-14.

Pilgrim TM, Wyss TR. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: a systematic review. Int J Cardiol. 2008 Mar 14;124(3):283-92.

Littlejohn FC, Syed O, Ornstein E, Connolly ES, Heyer EJ. Takotsubo cardiomyopathy associated with anesthesia: three case reports. Cases J. 2008 Dec;1(1):227.

Lentschener C, Vignaux O, Spaulding C, Bonnichon P, Legmann P, Ozier Y. Early postoperative tako-tsubo-like left ventricular dysfunction: transient left ventricular apical ballooning syndrome. Anesthesia Analgesia. 2006 Sep 1;103(3):580-2.

Jo YY, Park S, Choi YS. Extracorporeal membrane oxygenation in a patient with stress-induced cardiomyopathy after caesarean section. Anaesth Intensive Care. 2011 Sep;39(5):954-7.

Pearson TE, Frizzola MA, Priest MA, Rochman MF, Froehlich CD.Pediatric Extracorporeal Cardiopulmonary Resuscitation Patient With Traumatic Subarachnoid Hemorrhage and Takotsubo Syndrome. Air Med J. 2018;37(1):64-6.

Bhojraj S, Sheth S, Pahlajani D. Postoperative Takotsubo cardiomyopathy. Ann Card Anaesth. 2014 Apr-Jun;17(2):157-60.

Dorfman TA, Iskandrian AE. Takotsubo cardiomyopathy: state of the art review. J Nucl Cardiol. 2009;16(1):122-34.

Lyon AR, Bossone E, Schneider B, Sechtem U, Citro R, Underwood SR, et al. Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2016 Jan;18(1):8-27.

Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Internal Med. 2004 Dec 7;141(11):858-65.

Aggarwal N, Rai AK, Yizhak K, Saunders P, Tessler S. ECMO for cardiopulmonary rescue after near fatal Takotsubo cardiomyopathy. Chest. 2014 Oct 1;146(4):257A.