Hypotension After a Pediatric Invasive Procedure: Beware of Takotsubo Cardiomyopathy- Correspondence

  • John E. MadiasEmail author

To the Editor: The case of the unfortunate 14-y-old boy with the left bronchial malignant extrarenal rhabdoid tumor who suffered takotsubo syndrome (TTS), in the setting of undergoing rigid bronchoscopy, debulking of an intraluminal mass, and bronchial stenting, under general anesthesia, reported by Mohanty et al. [1], brings some thoughts to mind, that I wish to share with the authors: 1) The electrocardiogram (ECG) of the boy showed low amplitude QRS complexes in the limb, V1, and V6 lead, previously reported in association with TTS [2], and I wonder whether, a possible previous to the bronchoscopy ECG, showed larger QRS complexes in these leads. 2) The hypotension and bradycardia noted could be related to lingering vagal influences, related to the procedure, although vagal stimulation has been associated with TTS [3]. 3) Anesthesia could have been the trigger for TTS, as the authors hinted. 4) The desaturation could have been the trigger for TTS, viaa brain-heart pathophysiologic...


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© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Division of CardiologyElmhurst Hospital CenterElmhurstUSA

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