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Anesth Analg 2006;103:583-586
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000229707.46556.9d

CARDIOVASCULAR ANESTHESIA

Two Cases of Transient Left Ventricular Apical Ballooning Syndrome Associated with Subarachnoid Hemorrhage

Sumi Otomo, MD*, Michiko Sugita*, Osamu Shimoda{dagger}, and Hidenori Terasaki{dagger}

From the *Department of Anesthesiology, Kumamoto University Hospital, {dagger}Department of Anesthesiology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.

Electrocardiogram (ECG) abnormalities secondary to subarachnoid hemorrhage are well known, but the etiology remains unclear. Transient left ventricular apical ballooning syndrome is characterized by acute onset myocardial infarction-like symptoms, transient (reversible) cardiac dysfunction, and shapes resembling ampulla on left ventriculography. We managed general anesthesia for two patients with transient left ventricular apical ballooning and ECG abnormalities associated with subarachnoid hemorrhage. During anesthesia, their hemodynamic status was almost stable although their cardiac performance analyzed by transthoracic echocardiography and transesophageal cardiography was poor. Anesthetic management of this syndrome may be simplified if less cardiosuppressive anesthetic management is used. We recommend evaluating cardiac function with transthoracic echocardiography or transesophageal cardiography when an subarachnoid hemorrhage patient has ECG abnormalities.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.