Stress cardiomyopathy, Takotsubo cardiomyopathy, or acute neurocardiogenic heart failure syndrome?

Since its first description in Japan in 1990, Takotsubo syndrome, or stress cardiomyopathy (sCMO), goes by many monikers. The sCMO syndrome is characterised by a form of acute reversible myocardial injury characterised by transient regional systolic left ventricular (LV) dysfunction in a non-coronary distribution.

Supraclavicular regional anaesthesia affecting bispectral index as level of consciousness monitor (SUPRABLOC): a pilot randomised controlled trial

Recently there has been an increased interest in regional anaesthesia, especially during the COVID-19 pandemic, due to the avoidance of aerosol-generating procedures, reduced postoperative complications and the need to decrease the length of patients’ hospital stay.

The awareness of local anaesthetic systemic toxicity among registrars from surgical disciplines at a tertiary hospital, South Africa

The local anaesthetic (LA) effect of cocaine was discovered in the late 1800s and transformed the scope of medical practice. LA use by various healthcare professionals from various disciplines has increased over the years. Worldwide, approximately 6 million people are injected with LA agents each day. Many surgical procedures are performed using LA agents only, some of which are performed safely in remote settings outside a formal theatre facility.

Perioperative haemodynamic instability caused by Takotsubo cardiomyopathy

Takotsubo cardiomyopathy was first described in a Japanese case series. The patients typically presented with chest pain and ECG patterns consistent with an acute coronary syndrome; yet no angiographic evidence of coronary artery occlusion was demonstrated. Contrast ventriculography revealed an unusual pattern of regional wall motion abnormalities, creating the appearance of a narrow left ventricular (LV) base combined with outward ‘ballooning’ of the apex during systole.

Rare but fatal if missed – intraoperative Takotsubo syndrome in adult liver transplantation: lessons for anaesthesia and intensive care clinicians

A 55-year-old recipient underwent a deceased donor ABOcompatible whole liver transplant. The patient was known to the Wits Transplant Unit having been waitlisted for end-stage liver disease (ESLD) from steatohepatitis with progression to cirrhosis, complicated by portal hypertension, hepatic encephalopathy, and ascites that required multiple in-hospital admissions. Chronically, portal hypertension was managed using carvedilol, ascites with furosemide and spironolactone, with rifaximin and lactulose used for the management of hepatic encephalopathy.

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Southern African Journal of Anaesthesia and Analgesia - March/April 2023 Vol 29 No 2