Takotsubo syndrome (TTS) is a type of non-ischemic
cardiomyopathy characterized by an acute reversible
left ventricular dysfunction with typical apical ballooning, usually with subsequent complete recovery. Early diagnosis and prompt treatment are of great essence. Herein, we described a case of TTS of a patient who was scheduled initially for laparoscopic
endometrial cancer staging. The 69-year-old woman presented with
cardiogenic shock induced by the severe
anaphylactic reaction to the
antibiotics during
anesthesia induction.
Cardiopulmonary resuscitation (
CPR) was implemented while several boluses of 1 mg
epinephrine were injected. After the return of spontaneous circulation, a large number of orange peel-like
rash appeared on the head, face, neck, and trunk of the patient. Transesophageal echocardiography (TEE) revealed diffused decreased left ventricular systolic function. Therefore, veno-arterial
extracorporeal membrane oxygenation (VA-ECMO) and intra-aortic balloon pump (IABP) were applied in the intensive care unit.
Biomarkers like cardiac
troponin I (cTnI) subsequently decreased with improved cardiac insufficiency. Finally, the patient was discharged in good condition. This case demonstrated that TTS could be secondary to severe
anaphylactic shock and exogenous
catecholamines. With the consideration of the reversible condition and predictable recovery of TTS, early vigilance and advanced life support devices should be necessary.