Takotsubo cardiomyopathy secondary to elective sclerotherapy for varicose veins

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.