# Cardiac Anomaly: Reverse Takotsubo Following Gallbladder Surgery

## TL;DR

An 81-year-old woman developed reverse Takotsubo cardiomyopathy after gallbladder surgery, showing symptoms similar to a heart attack.

## Contribution

This case report highlights a rare instance of postoperative reverse Takotsubo cardiomyopathy in an elderly patient.

## Key findings

- The patient exhibited elevated troponin and beta-natriuretic peptide levels, suggesting acute cardiac stress.
- Echocardiogram findings were consistent with reverse Takotsubo cardiomyopathy following laparoscopic cholecystectomy.
- The case expands the understanding of postoperative stress-induced cardiomyopathy in older adults.

## Abstract

Takotsubo cardiomyopathy is an acute but often reversible left ventricular dysfunction commonly triggered by emotional stress. There are multiple variants within the general condition; however, reverse Takotsubo cardiomyopathy is a rare variant of stress-induced cardiomyopathy affecting the basilar segment of the left ventricle. This commonly manifests in younger women with clinical presentations similar to acute coronary syndrome. Cases of postoperative reverse Takotsubo cardiomyopathy are limited in the current literature. Hence, we present an 81-year-old female with shortness of breath and chest pain with exertion following a recent laparoscopic cholecystectomy. Based on her symptoms during the presentation, troponin and beta-natriuretic peptide were obtained. Results demonstrated an elevation in both markers, raising concerns for possible acute coronary syndrome (ACS). The patient subsequently underwent a transthoracic echocardiogram (TTE), which demonstrated findings consistent with reverse Takotsubo cardiomyopathy (rTTC). Therefore, we present a unique case of an 81-year-old female presenting with rTTC following laparoscopic cholecystectomy.