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VOLUME 26 , ISSUE 2 ( February, 2022 ) > List of Articles


Inverted Takotsubo Following a Ruptured Ectopic Pregnancy, Treated with Levosimendan

Anis Ghariani, Leila Dhiab, Fehmi Ferhi, Mohamed AB Abdessalem, Abdallah Mahdhaoui, Khaled B Jazia, Gouider Jeridi

Keywords : Echocardiography, Ectopic pregnancy, Heart failure, Levosimendan

Citation Information : Ghariani A, Dhiab L, Ferhi F, Abdessalem MA, Mahdhaoui A, Jazia KB, Jeridi G. Inverted Takotsubo Following a Ruptured Ectopic Pregnancy, Treated with Levosimendan. Indian J Crit Care Med 2022; 26 (2):228-230.

DOI: 10.5005/jp-journals-10071-24118

License: CC BY-NC 4.0

Published Online: 09-02-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background: Takotsubo syndrome is a transient stunned myocardium that typically involves the apical and mid-ventricular segments. A variant, called Inverted Takotsubo, concerns the basal and mid-ventricular segments. Case summary: We present a ruptured ectopic pregnancy that was responsible for a catecholamine surge, which led to this stress-induced cardiomyopathy. Transthoracic echocardiography showed mid-basal segments akinesia and hypercontractility of the apical segments. Biology has shown mild elevated troponin and NT-pro-BNP levels which led to performing a coronary angiography that showed no angiographic stenosis. A left ventricle angiography evoked the diagnosis of inverted Takotsubo. The patient has received Levosimendan to allow progressive weaning of catecholamine inotropes. The clinical evolution was favorable. Echocardiography performed after 3 weeks, showed ad-integrum restitution of the left ventricular function. Discussion: Takotsubo syndrome should be evoked whenever a context of physical or psychological stress is present. We underline the usefulness of Levosimendan as a nonadrenergic inotrope in this particular context.

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