General Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
General Medicine, Torbay and South Devon NHS Foundation Trust, Torquay, UK.
BMJ Case Rep. 2022 Jul 4;15(7):e250899. doi: 10.1136/bcr-2022-250899.
A man in his 70s presented to the emergency department with ongoing chest pain, which started directly after receiving sclerotherapy for the treatment of varicose veins. This was on a background of experiencing short-term chest pain twice previously following sclerotherapy. By the time he was seen, his pain had reduced significantly. ECG showed subtle ischaemic changes. Troponins were significantly raised. A transthoracic echocardiogram demonstrated apical akinesis. Coronary arteries were patent on angiography. A repeat echocardiogram in 4 weeks showed complete resolution of ventricular dysfunction. This represents the first reported case of Takotsubo cardiomyopathy following sclerotherapy in the UK. This case provides a useful learning opportunity for clinicians, to consider immediate investigation in the context of chest pain following sclerotherapy, and how to practically distinguish between Takotsubo cardiomyopathy and myocardial infarction in the differential diagnosis.
一位 70 多岁的男性因持续胸痛到急诊科就诊，胸痛直接发生在接受硬化疗法治疗静脉曲张之后。在此之前，他曾有过两次接受硬化疗法后出现短期胸痛的经历。就诊时，他的疼痛已明显减轻。心电图显示轻微的缺血性改变。肌钙蛋白显著升高。经胸超声心动图显示心尖部无运动。冠状动脉血管造影显示正常。4 周后再次进行超声心动图检查显示心室功能完全恢复。这是在英国首例报道的硬化疗法治疗后出现心尖球囊样综合征的病例。该病例为临床医生提供了一个有用的学习机会，使他们能够考虑在硬化疗法后出现胸痛的情况下进行即时检查，并了解如何在鉴别诊断中实际区分心尖球囊样综合征和心肌梗死。
