INTRODUCTION
Takotsubo Syndrome (TS), also known as acute left ventricle apical
ballooning syndrome or stress-induced cardiomyopathy, is a rare
condition, first described in Japan in the early 1990’s by Sato et
al[1], characterized by hypokinesis of the left ventricle and
ballooning of the apex, with hypercontractile base and non-obstructive
coronary artery disease, causing a transient but potentially lethal left
ventricle systolic disfunction. Despite clinical symptoms consistent
with acute myocardial infarction, normal coronary arteries are usually
detected upon cardiac catheterization. It is now recognized that in
addition to emotional stress, also surgical procedures and
administration of exogenous catecholamines play an important role as
precipitant factors of the disease. Here we describe a challenging case
of TS occurring after surgery for mitral valve repair complicated with
systolic anterior motion of the mitral valve (SAM), severe mitral
insufficiency and right ventricular disfunction.