Perioperative transient left ventricular apical ballooning syndrome: Takotsubo cardiomyopathy: a review

Transient left ventricular apical ballooning syndrome (TLVAB), also known as Takotsubo cardiomyopathy, is a cardiac syndrome characterized by transient left ventricular dysfunction in the absence of obstructive atherosclerotic coronary artery disease. An episode of emotional and/or physiologic stress frequently precedes presentation of this syndrome. TLVAB may initially present as an acute coronary syndrome characterized by chest pain, pulmonary edema, electrocardiographic changes, elevated cardiac enzymes, and cardiogenic shock. This syndrome is still underestimated today and the potential appearance of TLVAB during the perioperative period can be a great challenge. Adequate beta-blockade is the mainstay in the treatment of patients with TLVAB during the acute phase and also for long-term management. (C) 2010 Elsevier Inc. All rights reserved.