Case Report: Takotsubo cardiomyopathy caused by acute surgical pathology against the background of colorectal cancer

病例报告:结直肠癌背景下由急性外科手术病理引起的Takotsubo心肌病

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Abstract

We present a case of Takotsubo cardiomyopathy (TCM) in a young woman who has developed necrosis and perforation of the sigmoid intestine with a spontaneous opening of the abscess in the abdominal cavity, which caused purulent peritonitis. The patient underwent emergency surgical intervention. The postoperative period was complicated by a clinic of acute respiratory failure and bilateral pneumonia. In five days after surgery, the patient developed laboratory and instrumental signs of acute myocardial infarction. Changes similar to myocardial infarction appeared on electrocardiogram (ECG). Echocardiography revealed akinesis of the apical segments of the left ventricle and the ejection fraction of the left ventricle was reduced (LVEF) from 63 to 31%-35%. The level of NT-proBNP has increased significantly, but the level of troponin I increased to a lesser extent. Coronary angiography demonstrated normal arteries without any obstruction. As a result, a diagnosis Takotsubo cardiomyopathy caused by acute surgical pathology was made. In the future, the patient was discharged in a stable state. Subsequent echocardiography showed normalization of the systolic function of the left ventricle, the disappearance of ECG changes, and a decrease in the level of specific cardiomarkers.

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