Document Detail

"Broken heart" after cesarean delivery. Case report and review of literature.
MedLine Citation:
PMID:  21136269     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To present a rare case of a multiparous woman undergoing elective cesarean section with apparent symptoms of acute coronary syndrome and who was later diagnosed with Takotsubo cardiomyopathy (TCM; "broken heart syndrome"). To review similar case reports already reported in literature.
METHODS: Literature search on the occurrence of TCM in pregnancy using MEDLINE and Cochrane databases.
RESULTS: TCM might occur in women with no known pre-existing cardiomyopathy and uncomplicated pregnancies undergoing cesarean section, especially in combination with the administration of catecholamines/vasoconstrictive substances and possibly also oxytocin and prostaglandins.
CONCLUSIONS: Since TCM is related to emotional and physical stress, the surroundings during cesarean section should be kept quiet and smooth. Adrenergic stimulants (adrenaline, phenylephrine, ergonovine, ephedrine) and anticholinergics (atropine) should be used with caution and adequate volume substitution prior to the onset of spinal analgesia for the prevention of hypotension should be provided. If signs of an acute coronary syndrome during cesarean section do occur, echocardiography is obligatory for diagnosis of TCM.
Jarmila A Zdanowicz; Anja C Utz; Isabella Bernasconi; Sacha Geier; Roberto Corti; Ernst Beinder
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Publication Detail:
Type:  Journal Article     Date:  2010-12-07
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  283     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  687-94     Citation Subset:  IM    
Clinic of Obstetrics, Zurich University Hospital, Frauenklinikstrasse 10, 8091, Zurich, Switzerland,
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