Stress takotsubo cardiomyopathy after pylorus preserving pancreaticoduodenectomy for cancer. A case report.

A pylorus-preserving cephalic pancreaticoduodenectomy was performed for tumor removal in a male elderly patient. In the following course no surgical complications occurred but ST-elevations and increase of Troponin T were observed. A coronary angiography revealed no relevant stenosis although a severe hypokinesis of the apex region was determined by echocardiography--a Takotsubo syndrome was assumed. This led to a significant prolonged clinical course. No residual problems remained but the cause of Takotsubo could not be identified. Analyzing the current knowledge, a feasible preoperative screening for this severe condition seems to be quite impossible.