Síndrome de Takotsubo (cardiomiopatía del estrés) y secreción inapropiada de hormona antidiurética

El Sindrome de Takotsubo es una disfuncion ventricular aguda reversible en ausencia de obstruccion coronaria. Una mujer de 85 anos de edad con antecedentes de reemplazo valvular aortico transcateter, ingreso por dos semanas de dolor severo por una cadera desplazada por osteosintesis fallida. Mientras se programaba para cirugia, se documento hiponatremia severa secundaria a secrecion inapropiada de hormona antidiuretica. Subitamente desarrollo edema agudo pulmonar. El ecocardiograma confirmo una valvula protesica funcional y aquinesia medial y apical de las paredes del ventriculo izquierdo. Recibio tratamiento con ventilacion mecanica no invasiva, restriccion de liquidos y diureticos. La hiponatremia y la cardiomiopatia resolvieron. Takotsubo syndrome is a form of acute reversible left ventricular dysfunction in the absence of coronary obstruction. An 85-year-old lady with a medical history of transcatheter aortic valve replacement was readmitted complaining of 2 weeks of severe pain by a displaced hip and failed osteosynthesis. While she was scheduled for hip surgery, severe hyponatremia secondary to inappropriate antidiuretic hormone secretion was documented, and sudden-onset pulmonary edema ensued. Echocardiography confirmed normally functioning aortic prosthetic valve and classical features of Takotsubo. She was treated with non-invasive mechanical ventilation, water restriction, and diuretics. Hyponatremia and the cardiomyopathy resolved and the patient recovered completely.