# Τakotsubo Syndrome After Surgical Removal of the Thyroid Gland and Major Bleeding

## TL;DR

A 58-year-old man developed Takotsubo syndrome after thyroid surgery with major bleeding, showing heart dysfunction that resolved quickly.

## Contribution

This case highlights a rare instance of Takotsubo syndrome triggered by surgical and physical stress.

## Key findings

- The patient showed ST elevation and elevated troponin T after surgery, mimicking a heart attack.
- Coronary angiography revealed unobstructed arteries, confirming Takotsubo syndrome.
- Echocardiograms showed full recovery of heart function within days.

## Abstract

A 58-year-old male with a medical history of arterial hypertension, dyslipidemia, and psoriasis was admitted for a scheduled surgical removal of the thyroid gland. During the surgery, the patient suffered severe blood loss caused by vascular complications. After the operation, his electrocardiogram showed diffuse ST segment elevation along with high-sensitivity cardiac troponin T elevation and severe left ventricular systolic dysfunction. An emergency coronary angiography showed unobstructed coronary arteries. However, the left ventriculography demonstrated akinesia of the apical segments and hyperkinesia of the basal segments during systole. The patient was diagnosed with Takotsubo syndrome and he was successfully stabilized over the course of the next few days. Takotsubo cardiomyopathy is characterized by transient left ventricular systolic dysfunction and although the clinical and electrocardiographical presentation is similar to an acute coronary syndrome, the coronary arteries are unobstructed. Stressful events, both physical or psychological, could trigger an excessive catecholaminergic response which can cause the syndrome. Repetitive echocardiograms in our patient demonstrated complete recovery of the systolic function after a few days.