naa a22 4500 51074415X CHVBK 20180411083039.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12630-013-9964-0 doi (NATIONALLICENCE)springer-10.1007/s12630-013-9964-0 Broken heart syndrome triggered by an obstructive goiter not associated with thyrotoxicosis [Elektronische Daten] [Roupen Hatzakorzian, Helen Bui, Thomas Schricker, Steven Backman] Syndrome du cœur brisé déclenché par un goitre obstructif non associé à une thyrotoxicose Purpose: Takotsubo cardiomyopathy (TC) is described as transient ventricular dysfunction following emotional or physical trauma. A few reports have described patients with TC in association with various circumstances of thyrotoxicosis. We report an unusual case of TC in a patient with a large retrosternal goiter and normal thyroid function. We speculate that TC was triggered by compromise of tracheal flow induced by the goiter. Clinical feature: A 68-yr-old woman without primary heart disease presented with cardiorespiratory collapse requiring ventilatory and cardiovascular support, including placement of an intra-aortic balloon pump. She was diagnosed with a severe form of TC based on characteristic echocardiography findings and clinical course. Within less than a week, her myocardial function completely normalized. The patient was later found to have a large retrosternal goiter compressing her trachea, though her thyroid function was normal. A total thyroidectomy was eventually performed, and she made a full recovery. Subsequently, the patient was found to have a positive JAK2 mutation for a myeloproliferative disorder. Conclusions: Takotsubo cardiomyopathy may be regarded as the final common pathway of cardiac dysfunction triggered by various stress conditions, in this case, a large retrosternal goiter not associated with thyrotoxicosis and likely exacerbated by severe leukocytosis related to a myeloproliferative disorder. Canadian Anesthesiologists' Society, 2013 Hatzakorzian Roupen Department of Anesthesia and Critical Care, Royal Victoria Hospital, McGill University Health Centre, 687 Pine Avenue West S5.05, H3A 1A1, Montreal, QC, Canada aut Bui Helen Division of Endocrinology, Department of Pediatrics, McGill University Health Centre, Montreal, QC, Canada aut Schricker Thomas Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada aut Backman Steven Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/8(2013-08-01), 808-812 0832-610X 60:8<808 2013 60 12630 https://doi.org/10.1007/s12630-013-9964-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-9964-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hatzakorzian Roupen Department of Anesthesia and Critical Care, Royal Victoria Hospital, McGill University Health Centre, 687 Pine Avenue West S5.05, H3A 1A1, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Bui Helen Division of Endocrinology, Department of Pediatrics, McGill University Health Centre, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Schricker Thomas Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada aut NATIONALLICENCE 700 1- Backman Steven Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/8(2013-08-01), 808-812 0832-610X 60:8<808 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer