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Reverse Takotsubo-Kardiomyopathie – eine lebensbedrohliche Erkrankung

Erfolgreiche Reanimation einer 31 Jahre alten Frau mit kardiogenem Schock nach Zahnarztbesuch

Reverse takotsubo cardiomyopathy—a life-threatening disease

Successful resuscitation of a 31-year-old woman with cardiologic shock after a visit to the dentist

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Zusammenfassung

Eine 31-jährige Patientin wurde im Rahmen eines zahnärztlichen Eingriffs mit Lokalanästhesie bei Kammerflimmern reanimationspflichtig. Eine Hypothermiebehandlung wurde bereits in der Zahnarztpraxis begonnen. In der sofort durchgeführten Herzkatheterunterschung zeigte sich eine reverse Takotsubo-Kardiomyopathie. Bei protrahiertem kardiogenem Schock war ein ausreichender „cardiac index“ nur durch Kalzium-Sensitizer und aortale Gegenpulsation (IABP) zu erreichen. Trotz eines maximalen Werts der neuronspezifischen Enolase von 37,8 ng/ml konnte die Patientin am 19. Tage ohne neurologisches Defizit und mit einer normalen Ejektionsfraktion entlassen werden.

Abstract

We report on a 31-year-old woman requiring resuscitation because of ventricular fibrillation during a standard dental procedure with local anaesthesia. In cardiac ventriculography, reverse takotsubo cardiomyopathy was diagnosed. Because of protracted cardiogenic shock early treatment with calcium sensitizers, as well as the use of an intra-aortic ballon pump (IABP) were necessary to achieve stable hemodynamics. Despite a maximum neuron-specific enolase value of 37.8 ng/ml, the patient was released from the hospital 19 days after admission without a neurological deficit and with completely restored cardiac function.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Bleser, C. Weth und G. Görge geben an, dass keine Interessenkonflikte bestehen.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Innere Medizin II (Kardiologie, Pulmologie, Angiologie und Internistische Intensivmedizin), Klinikum Saarbrücken, Akademisches Lehrkrankenhaus der Universität des Saarlandes, Winterberg 1, 66119, Saarbrücken, Deutschland

    T. Bleser, C. Weth & G. Görge

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  1. T. Bleser
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  2. C. Weth
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  3. G. Görge
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Correspondence to T. Bleser.

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Bleser, T., Weth, C. & Görge, G. Reverse Takotsubo-Kardiomyopathie – eine lebensbedrohliche Erkrankung. Med Klin Intensivmed Notfmed 108, 675–678 (2013). https://doi.org/10.1007/s00063-013-0293-4

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  • DOI: https://doi.org/10.1007/s00063-013-0293-4

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