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Takotsubo Syndrome After Cardiopulmonary Resuscitation During Emergency Cesarean Delivery

Kraft, Katrina MD; Graf, Matthias MD; Karch, Martin MD; Felberbaum, Ricardo MD

doi: 10.1097/AOG.0000000000001850
Contents: Case Report

BACKGROUND: Takotsubo syndrome is a rare, stress-related, and reversible form of acute heart failure primarily affecting postmenopausal women. It is characterized by left ventricular dysfunction with a classic apical and midventricular wall motion abnormality (apical ballooning).

CASE: A 28-year-old woman, gravida 2 para 1, at 30 4/7 weeks of gestation was admitted with fetal bradycardia, a fully dilated cervix, and breech presentation. During emergency cesarean delivery, the patient had intraoperative cardiac arrest. Resuscitation was successful. Twelve hours postoperatively, after demonstrating symptoms of acute heart failure, she was diagnosed with Takotsubo syndrome.

CONCLUSION: Peripartum Takotsubo syndrome must be differentiated from peripartum cardiomyopathy. Cesarean delivery and sympathomimetic medications can increase the risk of occurrence. Early recognition and interdisciplinary management are essential in the prevention of serious and potentially fatal complications.

Cesarean delivery is considered an obstetric risk factor for Takotsubo syndrome, and early recognition and interdisciplinary management are essential to morbidity and mortality reduction.

Departments of Obstetrics and Gynecology and Cardiology, Klinikum Kempten Oberallgäu, Kempten, Germany.

Corresponding author: Katrina Kraft, MD, Department of Obstetrics and Gynecology, Klinikum Kempten Oberallgäu, Sana Kliniken AG, Robert-Weixler-Strasse 50, Kempten 87439, Germany; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented as a poster at the 61st Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe, October 19–22, 2016, Stuttgart, Germany.

Each author has indicated that he or she has met the journal’s requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.