KMID : 0358820110380010085
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Journal of Korean Society of Plastic and Reconstructive Surgeons 2011 Volume.38 No. 1 p.85 ~ p.88
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A Case Report of Takotsubo Cardiomyopathy During Breast Augmentation
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Lee Kyoung-Mook
Kim Youn-Hwan Kim Jeong-Tae Hwang Won-Jung Shin Jin-Ho
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Abstract
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Purpose: Takotsubo cardiomyopathy is a relatively uncommon type of stress-induced cardiomyopathy characterized by transient left ventricular regional wall motion abnormalities. Emotional and physical stresses play a key role in this type of cardiomyopathy in postmenopausal women. The current hypothesis is that the syndrome represents a form of catecholamine surge due to stress or epinephrine-mediated acute myocardial stunning.
Methods: A 44-year-old woman had suffered premature ventricular contraction following a cardiogenic shock during a breast augmentation surgery under enflurane anesthesia and tumescent solution infiltration. She was treated with cardiopulmonary resuscitation at a local clinic. Then she was brought to the Emergency Department of the authors¡¯ hospital.
Results: The woman¡¯s echocardiogram showed an ejection fraction of 20~25% with associated basal hyperkinesis and left ventricular apical ballooning. The patient was admitted to the ICU and required inotropic support for two weeks. The patient¡¯s condition dramatically improved, and her ejection fraction returned to 70%.
Conclusion: It is believed that there were multiple triggering factors of the onset of Takotsubo cardiomyopathy in the woman¡¯s social and family history, including infiltration of a large volume of the tumescent solution and VPCs induced by enflurane anesthesia without premedication. The importance of careful history-taking, careful pre-operative consultation on psychological suffering especially for breast surgery, premedication before surgery, patient reassurance, and post-operative psychosocial and emotional assistance was again seen in this case.
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KEYWORD
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Takotsubo cardiomyopathy, Breast augmentation
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