Tako-tsubo cardiomyopathy is a recently described form of transient
ventricular dysfunction that is not associated with coronary vessels obstruction, although its clinical manifestations are often similar to those of
myocardial ischemia. This syndrome is possibly due to an excess of
catecholamines, and it is associated with emotional and physical stress and surgery. However, the pathophysiological relation to anaesthesia has not yet been clarified. We report a case of
Tako-tsubo cardiomyopathy that ensued immediately after induction of general anaesthesia for elective surgery in a patient submitted to
laparoscopic cholecystectomy. The patient was first treated as if affected by
myocardial ischemia, but a rapidly performed emergency coronary angiography showed normal epicardial coronary vessels with a significant reduction of left ventricular function. The coronary angiography ruled out the diagnosis of typical
myocardial ischemia and allowed for the arrival at the correct diagnosis. The transient ventricular ballooning was attributed to the recently described
Tako-tsubo syndrome. Prompt treatment allowed control of symptoms, and the patient was safely treated and discharged on day 15. Although it is difficult to identify the cause of this syndrome, it may be argued that, during general anaesthesia and particularly at induction, the imperfect control of
catecholamine excess may induce cardiac damage in predisposed subjects.