Takotsubo Cardiomyopathy Following Emergency Cesarean Section: A Rare Peripartum Presentation

紧急剖宫产后发生Takotsubo心肌病:一种罕见的围产期表现

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Abstract

Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy or transient left ventricular ballooning, presents with suspicion of an acute myocardial infarction characterized by temporary apical or midventricular dyskinesia of the left ventricle, despite normal findings on coronary angiography. This temporary cardiac condition is frequently triggered by episodes of emotional or physical stress. We present an unusual case of TCM occurring immediately after an emergency cesarean section in a 41-year-old woman diagnosed with gestational diabetes. The patient experienced acute respiratory distress and chest discomfort soon after being extubated, necessitating reintubation and intensive care unit management. Electrocardiogram showed nonspecific ST-T changes and mild ST elevation in V1-V2, and echocardiogram results indicated apical and midventricular akinesia along with a decreased ejection fraction, consistent with TCM diagnosis. A subsequent coronary angiography displayed normal coronary arteries. The patient was treated conservatively with supportive measures and cardiac medications. This case report underscores the importance of identifying stress-induced cardiomyopathy during the peripartum period, particularly following high-stress obstetric procedures.

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