Abstract
A 66-year-old female was brought to the emergency department for acute-onset left-sided chest pain. Prior to arrival, she was at an outpatient appointment with a vascular surgeon for elective sclerotherapy treatment of her lower extremity varicose veins. After receiving an IV injection of polidocanol, she developed severe chest pain with left arm and jaw numbness for the first time in her life. Upon arrival to the ED, the patient reported that her symptoms had resolved. Electrocardiogram (ECG) on presentation was significant for T-wave inversions in leads V1-V3. An initial set of cardiac enzymes showed a troponin I level of 0.62 ng/mL, which subsequently increased to 2.26 ng/mL. Her echocardiogram was significant for mild left ventricular systolic dysfunction with apical hypokinesis (ejection fraction 50%). A repeat ECG showed new T-wave inversions compared to that from the time of admission. The patient eventually agreed to cardiac catheterization, which revealed patent vessels without coronary artery disease, supporting our diagnosis of Takotsubo syndrome and what is the first reported case of likely polidocanol-induced Takotsubo syndrome in the United States.
Highlights
Takotsubo syndrome is typically caused by significant emotional or physical stress and is considered nonischemic in nature
We present a case of a 66-year-old female who presented to the ED with severe chest pain and was later diagnosed with Takotsubo syndrome after being administered polidocanol, a commonly used sclerotherapy agent
A 66-year-old female with no significant past medical history was brought to the emergency department by emergency medical services (EMS) with a complaint of left-sided chest pain
Summary
Takotsubo syndrome is typically caused by significant emotional or physical stress and is considered nonischemic in nature. The condition can be diagnosed in patients with less typical presentations and histories as well. We present a case of a 66-year-old female who presented to the ED with severe chest pain and was later diagnosed with Takotsubo syndrome after being administered polidocanol, a commonly used sclerotherapy agent
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