Two case studies of cardiac arrest occurring in medically fit patients undergoing radical hysterectomy for cervical cancer

• Main Authors: Bernd C. Schmid, Rex Yuan, Leonie Watterson, Jennifer Yu, Neville Hacker
• Format: Article
• Language: English
• Published: Elsevier 2021-08-01
• Series: Gynecologic Oncology Reports
• Subjects: Takotsubo cardiomyopathy; Cervical cancer; Surgery for cervical cancer; Cardiac arrest
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352578921001272

We report case histories of two young women who had an intraoperative cardiac arrest, potentially caused by preoperative emotional stress, while undergoing open radical hysterectomy for cervical cancer. Neither had any history of heart disease or other comorbidities. Takotsubo cardiomyopathy, a form of stress cardiomyopathy characterized by acute reversible ventricular dysfunction that can occur in the perioperative period, was the cause in one patient. A vasovagal episode during the exploration of the abdomen was the cause in the other. Successful resuscitation and stabilisation of both patients made it possible to continue the surgery and successfully complete both procedures. Takotsubo cardiomyopathy should be considered in any patient showing significant preoperative stress who has a cardiac arrest, even if there is no preoperative morbidity. It is difficult to differentiate from a vasovagal episode intraoperatively. Surgical and anaesthetic teams should be aware of importance of countering severe preoperative stress.