Patel Sunny, Nabatian Sepideh, Goyfman Michael
Department of Medicine, Long Island Jewish Forest Hills, Northwell Health, New York, USA.
Department of Cardiology, Long Island Jewish Forest Hills, Northwell Health, New York, USA.
Case Rep Cardiol. 2020 Jan 14;2020:5626078. doi: 10.1155/2020/5626078. eCollection 2020.
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.
一名66岁女性因突发左侧胸痛被送往急诊科。在到达之前，她正在血管外科门诊接受下肢静脉曲张的选择性硬化治疗。在接受聚多卡醇静脉注射后，她生平第一次出现了严重胸痛，并伴有左臂和下巴麻木。到达急诊科时，患者报告症状已缓解。入院时的心电图显示V1-V3导联T波倒置。最初的一组心肌酶显示肌钙蛋白I水平为0.62 ng/mL，随后升至2.26 ng/mL。她的超声心动图显示轻度左心室收缩功能障碍伴心尖运动减弱（射血分数50%）。与入院时相比，复查心电图显示出现新的T波倒置。患者最终同意进行心脏导管插入术，结果显示血管通畅，无冠状动脉疾病，支持我们对Takotsubo综合征的诊断，这也是美国首例可能由聚多卡醇诱发的Takotsubo综合征报告病例。
