<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2022-0002_s_005"><h3>Introduction</h3>
<p>Takotsubo cardiomyopathy is a rare reversible type of heart failure, often precipitated by emotional stress; other risk factors include intracranial bleeding, ischemic stroke, sepsis, major surgery, pheochromocytoma. The clinical, electrical and blood sample analysis features resemble those of a myocardial infarction- however, they occur in the absence of angiographic coronary filling defects.</p>
</sec>
<sec id="j_jccm-2022-0002_s_006"><h3>Case presentation</h3>
<p>A 61-year-old male patient, 71 kg, 175 cm, underwent liver transplantation for Child-Pugh B cirrhosis secondary to mixed viral hepatitis (B and D). His medical records revealed mild mitral, aortic, and tricuspid insufficiencies and heart failure with preserved ejection fraction. An initially uneventful perioperative stage was succeeded by cardiogenic shock (cardiac index – 1.2 l/min/ sqm), which the patient developed 24 hours after the intervention. Elevated cardiac markers and ECG abnormalities showing ST-T changes in the V2-V5 leads were additionally noted. Transesophageal echocardiography (TEE) revealed an acute onset reduction in the left ventricular systolic function secondary to basal hypokinesia. No coronary obstruction was detected by percutaneous angiography. The above findings lead to the diagnosis of reverseTakotsubo cardiomyopathy. Further, the patient developed acute kidney injury and liver graft failure, succumbing within 48 hours after the surgical procedure.</p>
</sec>

<sec id="j_jccm-2022-0002_s_007"><h3>Conclusions</h3>
<p>We report a rare case of reverse Takotsubo cardiomyopathy in a male patient after orthotopic liver transplant.</p>
</sec>

</abstract>

Introduction
Takotsubo cardiomyopathy is a rare reversible type of heart failure, often precipitated by emotional stress; other risk factors include intracranial bleeding, ischemic stroke, sepsis, major surgery, pheochromocytoma. The clinical, electrical and blood sample analysis features resemble those of a myocardial infarction- however, they occur in the absence of angiographic coronary filling defects.

Case presentation
A 61-year-old male patient, 71 kg, 175 cm, underwent liver transplantation for Child-Pugh B cirrhosis secondary to mixed viral hepatitis (B and D). His medical records revealed mild mitral, aortic, and tricuspid insufficiencies and heart failure with preserved ejection fraction. An initially uneventful perioperative stage was succeeded by cardiogenic shock (cardiac index – 1.2 l/min/ sqm), which the patient developed 24 hours after the intervention. Elevated cardiac markers and ECG abnormalities showing ST-T changes in the V2-V5 leads were additionally noted. Transesophageal echocardiography (TEE) revealed an acute onset reduction in the left ventricular systolic function secondary to basal hypokinesia. No coronary obstruction was detected by percutaneous angiography. The above findings lead to the diagnosis of reverseTakotsubo cardiomyopathy. Further, the patient developed acute kidney injury and liver graft failure, succumbing within 48 hours after the surgical procedure.


Conclusions
We report a rare case of reverse Takotsubo cardiomyopathy in a male patient after orthotopic liver transplant.

Reverse Takotsubo cardiomyopathy after orthotopic liver transplantation. A case report

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction
Takotsubo cardiomyopathy is a rare reversible type of heart failure, often precipitated by emotional stress; other risk factors include...

Reverse Takotsubo cardiomyopathy after orthotopic liver transplantation. A case report

Article Category: Case Report

Published Online: May 12, 2022

Page range: 117 - 122

Received: Dec 20, 2021

Accepted: Mar 19, 2022

DOI: https://doi.org/10.2478/jccm-2022-0002

Keywords
orthotopic liver transplantation, reverse Takotsubo, cardiogenic shock

© 2022 Lucian Mihalcea, Isac Sebastian, Mihail Simion-Cotorogea, Artsiom Klimko, Gabriela Droc, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Reverse Takotsubo cardiomyopathy after orthotopic liver transplantation. A case report

Article Category: Case Report

Published Online: May 12, 2022

Page range: 117 - 122

Received: Dec 20, 2021

Accepted: Mar 19, 2022

DOI: https://doi.org/10.2478/jccm-2022-0002

Keywordsorthotopic liver transplantation, reverse Takotsubo, cardiogenic shock

© 2022 Lucian Mihalcea, Isac Sebastian, Mihail Simion-Cotorogea, Artsiom Klimko, Gabriela Droc, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
orthotopic liver transplantation, reverse Takotsubo, cardiogenic shock