# When the Heart Breaks in the Operating Room (OR): Intraoperative Arrest as a First Sign of Takotsubo Cardiomyopathy

## TL;DR

A patient had a heart attack during surgery, leading to the diagnosis of a rare heart condition called Takotsubo cardiomyopathy.

## Contribution

Highlights Takotsubo cardiomyopathy as a possible cause of intraoperative cardiac arrest in otherwise healthy patients.

## Key findings

- Intraoperative cardiac arrest can be the first sign of Takotsubo cardiomyopathy.
- Early recognition and multidisciplinary management are crucial for favorable outcomes.
- Takotsubo cardiomyopathy should be considered in differential diagnosis of perioperative cardiac arrest.

## Abstract

Cardiac arrest in the operating room is a rare but potentially life-threatening event. This report discusses a case in which a seemingly healthy patient presented for elective total thyroidectomy and experienced intraoperative cardiac arrest requiring cardiopulmonary resuscitation. Takotsubo cardiomyopathy was diagnosed following resuscitation. This case underscores the need for heightened awareness and consideration of Takotsubo cardiomyopathy as a differential diagnosis in cases of perioperative cardiac arrest, particularly when initial findings do not align with typical causes such as myocardial infarction or arrhythmia. Multidisciplinary collaboration, early recognition, and appropriate management are crucial to ensuring patient safety and achieving favorable recovery in such complex clinical scenarios.