I enjoyed reading the case report about Takotsubo cardiomyopathy after general anesthesia by Gavish et al.  in the September 2006 issue of Anesthesiology.1It is noteworthy that another case report of postoperative Takotsubo-like left ventricular dysfunction that occurred in France was published in the same month in the September 2006 issue of Anesthesia & Analgesia  2and was accompanied by an editorial that also emphasized the importance to anesthesiologists of this recently recognized form of transient reversible left ventricular dysfunction.3It should be noted that there has been at least one previous case of postoperative transient apical ballooning syndrome in a white female reported by Ramakrishna et al.  4 

It is interesting to ponder why these case reports are appearing now. I suspect it relates to the old adage that “we only see what we look for.”

University of Kentucky College of Medicine, Lexington, Kentucky. ehessel@uky.edu

Gavish D, Rozenman Y, Hafner R, Bartov E, Ezri T: Takotsubo cardiomyopathy after general anesthesia for eye surgery. Anesthesiology 2006; 105:621–3
Lentschener C, Vignaux O, Spaulding C, Bonnichon P, Legmann P, Ozier Y: Early Postoperative Tako-Tsubo -like left ventricular dysfunction: Transient left ventricular apical ballooning syndrome. Anesth Analg 2006; 103:580–2
Hessel EA: The brain and the heart (editorial). Anesth Analg 2006;103:522–6
Ramakrishna G, Ravi BS, Chandrasekaran K: Apical Ballooning syndrome in a postoperative patient with normal microvascular perfusion by myocardial contrast echocardiography. Echocardiography 2005; 22:606–10