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Reverse Takotsubo syndrome, a case report of a rare cause for postpartum heart failure

机译：Takotsubo综合征逆转，一例罕见的产后心力衰竭原因报告

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Predominant causes for newly diagnosed postpartum heart failure are preeclampsia and peripartum cardiomyopathy. Being an anatomical variant of Takotsubo syndrome (TTS) reverse TTS in this period is rare. We present a 36 year old patient, who had delivered triplets by cesarean section. Because of postpartum bleeding she was administered sulprostone. Later she was transferred to the Intensive Care Unit with sudden development of dyspnea, tachypnea and tachycardia. Clinical symptoms, laboratory findings and chest radiograph showed signs of acute heart failure. Transthoracic echocardiography (TTE) revealed reverse TTS with moderately reduced left ventricular ejection fraction (LVEF 39%). The patient stabilized with loop diuretic, angiotensine-converting enzyme inhibitors and beta-blockade. Breast-feeding was discouraged and bromocriptine administered. Left ventricular function normalized (LVEF 60%) within four weeks. TTS should be considered in patients with early postpartum development of heart failure. Rapid cardiac recompensation after the start of adequate therapy and complete resolution of clinical symptoms and TTE findings are typical for postpartum TTS.
机译：新诊断为产后心力衰竭的主要原因是先兆子痫和围产期心肌病。作为Takotsubo综合征（TTS）的解剖学变异，在此期间反向TTS很少见。我们介绍了一名36岁的患者，该患者按剖宫产分娩了三胞胎。由于产后出血，她被给予了舒普罗酮。后来，她被转移到重症监护病房，突然出现呼吸困难，呼吸急促和心动过速。临床症状，实验室检查结果和胸部X光片显示了急性心力衰竭的迹象。经胸超声心动图（TTE）显示反向TTS伴有左心室射血分数（LVEF 39％）适度降低。患者使用loop利尿剂，血管紧张素转化酶抑制剂和β-受体阻滞剂稳定。不鼓励母乳喂养并使用溴隐亭。四周内左心室功能恢复正常（LVEF 60％）。患有产后心力衰竭的早期患者应考虑使用TTS。开始适当治疗后迅速进行心脏补偿，并完全消除临床症状和TTE发现，这是产后TTS的典型表现。

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