title: The first case of takotsubo cardiomyopathy associated with sodium tetradecyl sulphate sclerotherapy.
abstract: The present article describes the case of a 70-year-old woman who developed a classic type takotsubo cardiomyopathy after receiving cosmetic sclerotherapy for varicose veins of the legs with sodium tetradecyl sulphate (STS) injections. The patient was in her usual state of health before the injections, and described no apprehension leading up to the procedure and no pain during the procedure. However, a few minutes after the completion of the procedure, the patient had severe chest pain of sudden onset and an electrocardiogram highly suggestive of ST elevation myocardial infarction. The patient was referred for emergent coronary angiography, which was normal. Subsequent ventriculography confirmed the suspected apical ballooning typical of takotsubo cardiomyopathy. Ventricular function returned to near-normal within three days of presentation. The present article describes what is believed to be the first case of takotsubo cardiomyopathy associated with the use of STS. A review of adverse events ascribed to STS revealed visual disturbances and transient ischemic attacks, suggesting the possibility of a common underlying vasospastic pathophysiology and an under- recognized vasoactive potential of STS that merits further investigation. In the interim, the present case advocates for the recommendation of universal pretreatment test dosing.
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Hôtel-Dieu Hospital, Quebec. brianjpotter@gmail.com
authors.forename: Brian
authors.initials: B
authors.lastname: Potter
authors.forename: François
authors.initials: F
authors.lastname: Gobeil
authors.forename: Albert
authors.initials: A
authors.lastname: Oiknine
authors.forename: Pierre
authors.initials: P
authors.lastname: Laramée
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D012597:Sclerosing Solutions / Q000009:adverse effects*; D015911:Sclerotherapy / Q000009:adverse effects*; D012981:Sodium Tetradecyl Sulfate / Q000009:adverse effects*; D054549:Takotsubo Cardiomyopathy / Q000209:etiology*; D014648:Varicose Veins / Q000628:therapy
chemical_list: D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate
references.citation: Angiology. 2007 Oct-Nov;58(5):644-6
references.pmid: 18024951
references.citation: Eur J Vasc Endovasc Surg. 2007 Aug;34(2):232-5
references.pmid: 17507258
references.citation: Int J Cardiol. 2006 Jun 7;110(1):7-14
references.pmid: 16249041
references.citation: Circulation. 2008 Dec 16;118(25):2754-62
references.pmid: 19106400
references.citation: J Cardiovasc Surg (Torino). 2006 Feb;47(1):9-18
references.pmid: 16434941