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Atypical Takotsubo Cardiomyopathy after Xylocaine Injection During Dental Procedure
並列摘要
Introduction: Takotsubo cardiomyopathy (TTC) is an entity firstly described in 1991, characterized by acute but reversible left ventricular systolic dysfunction in the absence of atherosclerotic coronary artery disease. Acute physical or psychological stresses seem to be the most common causes of takotsubo. We reported a case of atypical TTC, during a dental procedure, including 2% xylocaine injection into gum. Case Report: A 51-year-old Caucasian female with a past medical history of depression underwent dental procedure. The dentist injected a solution of 2% xylocaine into the gum and three minutes following the procedure, the patient complained for chest pain, during one hour. Electrocardiogram revealed T waves inversions into inferolateral leads. Troponin level performed at admission was 23ng/mL (N≤0.05). Clinical examination, echocardiography and coronary angiography were normal.Cardiac magnetic resonance imaging (MRI) found a global left ventricular hypokinesis, with ejection fraction of 40%, without late Gadolinium enhancement. Conclusion: This case reports an atypical presentation of TTC, induced by xylocaine injection, during the dental procedure. This is an unexpected cardiac side effect of the xylocaine drug mechanism. This case has an interest for the specialties of emergency medicine, cardiology and for dentists usual practice.
延伸閱讀
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