Case report: inverted Takotsubo syndrome secondary to stress during anesthesia

Case presentation Patient informationA 68-year-old male with type 2 diabetes mellitus and renal lithiasis presented to the emergency department intubated and receiving vasopressor support.His condition deteriorated intraoperatively during preparation for lithotripsy under anesthesia.Following a subarachnoid block, he developed a hypertensive crisis, profuse diaphoresis, precordial pain, vertigo, and subsequent syncope.The anesthesiology team-initiated intubation, central venous catheter placement, and vasopressor administration. Clinical findingsElectrocardiography (ECG) showed significant ST-segment depression in the inferoanterior leads (DII, DIII, aVF, V3-V6) (Fig. 1A), raising concerns about an acute coronary event.Initial blood tests revealed a