Síndrome de Tako-Tsubo em Decorrência de Bloqueio Neuromuscular Residual. Relato de Caso* Tako-Tsubo Syndrome Secondary to Residual Neuromuscular Blockade. Case Report

SUMMARY Cruvinel MGC, Carneiro FS, Bessa Jr RC, Silva YP, Marques MB —Tako-Tsubo Syndrome Secondary to Residual Neuromuscular Blo-ckade. Case Report. BACKGROUND AND OBJECTIVES: Tako-Tsubo syndrome is arare postoperative complication with a 5% mortality rate. The objec-tive of this report was to present residual neuromuscular blockadeas a trigger for this syndrome, discuss this disorder, and call atten-tion to the risks of residual neuromuscular blockade. CASE REPORT: A 61-year old female, physical status ASA I, whounderwent general anesthesia associated with paravertebral cer-vical block for arthroscopic repair of a rotator cuff lesion. Physicalexam after extubation detected residual neuromuscular blockade.In the post-anesthetic care unit the patient developed somnolence,tachycardia, hypertension, and severe respiratory acidosis. Afterreintubation the patient evolved for cardiac arrest with electricalactivity without a pulse, which was reverted with the administrationof adrenaline and external cardiac massage. In the postoperativeperiod the patient presented elevation of the ST segment, increasedtroponin, and left ventricular medial-apical akinesia with anestimated ejection fraction of 30%. Cardiac catheterization showedabsence of significant atheromatous lesions in the coronary ves-sels, and severe disruption of the systolic function with inferior andantero-septo-apical akinesia and compensatory basal hypercon-tractility. The patient had complete functional recovery with thetreatment instituted.