558 BIVENTRICULAR PERIOPERATIVE TAKOTSUBO CARDIOMIOPATHY

Abstract Introduction Perioperative Takotsubo cardiomyopathy (pTC) represents a rare and still not well characterized disease. Biventricular involvement is an uncommon manifestation of TC associated with more severe clinical presentation. Case report A 72-year-old male, hospitalized for laparoscopic left hemicolectomy, was transferred to ICU after having developed bradycardia, treated Adrenalin, cardiogenic shock during induction general anesthesia. EKG showed complete atrio-ventricular block, so temporary PMK placed. Troponin raised. Echocardiogram biventricular disfunction (LVEF 25%, TAPSE 12 mm) akinesia medio-apical segments, suggesting pTC. Also, there reduction 3D LV longitudinal strain (- 5,8%), particularly the portion, RV free wall 11%). Coronary angiography resulted negative. Patient's hemodynamic supported Noradrenalin cycle Levosimendan, allowing reach stability. Further echocardiogram improvement function values. Due persistency definitive Patient discharged therapy optimization. Discussion pTC little-known disease, as incidence etiology are definite. Literature suggests relation between physical or emotional stress due surgery promote increase catecholamine release. Other potential factors may be inadequate depth anesthesia tracheal manipulation intubation catecholaminergic drugs administration. On other hand, use anesthetic volatile agents seems have cardioprotective effect. PTC common when occurs intraoperatively has worse involvement, which TC, been reported frequently among patients. To date, lack systematic review, little knowledge about risk factors, prevention strategies management Conclusions Despite multiple cases reported, several characteristics this entity fully understood. However, it must considered part differential diagnosis in patients anaesthesia-related decompensation. infrequent presentation its commonly life-threating impairment.