ABSTRACT
INTRODUCTION AND IMPORTANCE: Takotsubo syndrome (TTS) is a reversible form of acute heart failure often triggered by physical or emotional stressors. Minimally invasive mitral valve surgery (MIMVS) has become a prevalent approach for treating mitral valve pathologies, yet its association with TTS remains underexplored. CASE PRESENTATION: We present the case of a female patient undergoing MIMVS with concomitant Maze ablation, who developed TTS postoperatively. Despite a normal coronary angiogram, transient coronary spasm due to an imbalance in autonomic nervous activity was considered. The patient exhibited preoperative risk factors including sequelae of cerebral infarction. CLINICAL DISCUSSION: Female patients undergoing MIMVS with preoperative risk factors such as cerebral infarction sequelae may be at increased risk of developing TTS postoperatively. CONCLUSION: The InterTAK Diagnostic score, in conjunction with the International Expert Consensus Document on Takotsubo Syndrome, aids in promptly diagnosing TTS and differentiating it from acute coronary syndrome. Further research is warranted to elucidate the relationship between MIMVS and TTS.