Our Summary

This research paper is about a rare heart condition called Takotsubo cardiomyopathy (TC). This condition causes a temporary and reversible abnormality in the lower part of the left heart chamber. It looks like a heart attack, but happens without any blockage in the heart arteries. Though it’s rare, TC can sometimes occur after heart surgery and can be life-threatening.

The researchers present a case where a 66-year-old man developed TC after having heart surgery. The man’s condition got worse after surgery, and he needed support from a device that helps the heart pump blood (intra-aortic balloon pump) and another machine that adds oxygen to the blood and pumps it through the body (extracorporeal membrane oxygenation). Luckily, the man’s heart function returned to normal in 2 weeks.

The researchers conclude that doctors should be aware of the possibility of TC after heart surgery. If a patient’s left heart chamber isn’t working properly after surgery, doctors should consider TC as a possible reason. They also discuss the causes and treatment of TC after surgery.

FAQs

  1. What is Takotsubo cardiomyopathy (TC) and how is it related to cardiac surgery?
  2. What complications can occur postoperatively after a pericardiectomy?
  3. How is postoperative TC diagnosed and treated in patients following cardiac surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to be aware of the potential risk of developing Takotsubo cardiomyopathy (TC) after the surgery. It is important for patients to monitor their symptoms closely after the procedure and seek medical attention if they experience any signs of heart dysfunction, such as chest pain, shortness of breath, or abnormal heart rhythms. Early detection and treatment of TC can lead to a better outcome and prevent potential complications.

Suitable For

Patients who are typically recommended for pericardiectomy are those who have constrictive pericarditis, chronic pericardial effusion, or recurrent pericarditis that is not responding to medical treatment. Additionally, patients with tumors or cysts in the pericardial sac may also be recommended for pericardiectomy. In some cases, patients with Takotsubo cardiomyopathy may also require pericardiectomy if they experience complications such as hemodynamic instability postoperatively.

Timeline

  • Before pericardiectomy: A 66-year-old man undergoes a pericardiectomy due to a medical condition affecting the pericardium.
  • After pericardiectomy: The patient experiences exacerbation of hemodynamic instability postoperatively and is diagnosed with Takotsubo cardiomyopathy (TC), a temporary and reversible systolic abnormality of the left ventricle’s apical area.
  • Post-diagnosis: The patient is supported by an intra-aortic balloon pump (IABP) and extracorporeal membrane oxygenation (ECMO) to stabilize his condition.
  • Recovery: The patient’s left ventricle function fully recovers within 2 weeks after the onset of TC.
  • Conclusion: It is important to consider the possibility of TC as a potential complication following cardiac surgery, and to be aware of the pathogenesis and treatment options for this condition.

What to Ask Your Doctor

  1. What is Takotsubo cardiomyopathy and how does it relate to my recent pericardiectomy surgery?
  2. What are the symptoms of Takotsubo cardiomyopathy and how will I know if I am experiencing it?
  3. What treatment options are available if I develop Takotsubo cardiomyopathy after my pericardiectomy?
  4. What are the potential risks and complications associated with Takotsubo cardiomyopathy following surgery?
  5. How long does it typically take for the left ventricle function to recover in cases of Takotsubo cardiomyopathy?
  6. Are there any lifestyle changes or medications I should consider to reduce the risk of developing Takotsubo cardiomyopathy in the future?
  7. How common is Takotsubo cardiomyopathy following pericardiectomy surgery, and what steps can be taken to prevent it?
  8. Should I be monitored more closely for signs of Takotsubo cardiomyopathy in the weeks and months following my surgery?
  9. Are there any specific warning signs or symptoms I should watch for that may indicate the development of Takotsubo cardiomyopathy?
  10. Is there any additional information or resources available for patients who have undergone pericardiectomy and may be at risk for Takotsubo cardiomyopathy?

Reference

Authors: Zhang H, Liao X. Journal: J Card Surg. 2021 Nov;36(11):4413-4415. doi: 10.1111/jocs.15948. Epub 2021 Aug 29. PMID: 34459034