Takotsubo cardiomyopathy developed during rewarming of accidental hypothermia with extracorporeal membrane oxygenation

Abstract

BACKGROUND: We here present the first case report of takotsubo cardiomyopathy that developed during rewarming of a patient with severe accidental hypothermia with extracorporeal membrane oxygenation. CASE: A 74-year-old woman was found unresponsive outdoors and suffered cardiopulmonary arrest during transfer to our hospital. On arrival, she was still in cardiopulmonary arrest. Veno-arterial extracorporeal membrane oxygenation was initiated for resuscitation and rewarming. After admission to the intensive care unit, her blood pressure suddenly dropped, and coronary angiography on day 2 indicated intact coronary arteries. Left ventriculography showed typical takotsubo-like dysfunction in the end-systolic phase, which led to the diagnosis of takotsubo cardiomyopathy. Left ventricular wall motion gradually improved, and echocardiography on day 6 revealed that abnormalities in the left ventricular wall motion had almost disappeared. CONCLUSION: Takotsubo cardiomyopathy might arise during rewarming of patients with severe accidental hypothermia.