Takotsubo cardiomyopathy after microwave ablation for metastatic liver lesions

Cardiovasc Revasc Med. 2017 Oct-Nov;18(7):526-527. doi: 10.1016/j.carrev.2017.04.016. Epub 2017 Apr 29.

Abstract

Takotsubo cardiomyopathy (TCMP) is characterized by transient and reversible left ventricular regional wall motion abnormalities triggered by acute and intense emotional or physical stress. We present a case of a 79 year old woman with a hypertensive crisis after microwave ablation (MWA) for metastatic liver lesions. Initial evaluation suggested an acute coronary syndrome with an ST segment elevation and with elevated serum troponin T. No associated chest pain or dyspnea was present. Further evaluation with ECG, echocardiography, coronarography with left ventricle angiogram and MRI was consistent with an apical ballooning syndrome. She was managed medically and the abnormalities resolved in the next 8 weeks during her follow up. The association between MWA and TCMP has been only reported once in the literature. We would like to emphasize one of the risks of MWA in or near the thoracic region potentially leading to TCMP.

Keywords: Liver metastasis; Microwave ablation (MWA); Takotsubo cardiomyopathy.

Publication types

  • Case Reports

MeSH terms

  • Ablation Techniques / adverse effects*
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure* / drug effects
  • Cardiac Imaging Techniques
  • Electrocardiography
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Microwaves / adverse effects*
  • Sigmoid Neoplasms / pathology*
  • Takotsubo Cardiomyopathy / diagnostic imaging
  • Takotsubo Cardiomyopathy / drug therapy
  • Takotsubo Cardiomyopathy / etiology*
  • Takotsubo Cardiomyopathy / physiopathology
  • Treatment Outcome
  • Ventricular Function, Left* / drug effects

Substances

  • Antihypertensive Agents