ABSTRACT
BACKGROUND AND OBJECTIVES:
Takayasu’s arteritis (TA) is a rare form of chronic inflammatory disease involving large vessels, with uncertain etiology, with chest pain as a common and challenging symptom, resulting from inflammation in the aortic root or arch, pulmonary artery or coronary arteries. The objective of this study was to describe the use of intravenous lidocaine to treat severe and refractory chest pain secondary to TA.
CASE REPORT:
A 33-year-old female patient diagnosed with TA, with severe chest pain that was difficult to manage, was admitted after consulting an emergency department. The pain was unresponsive to traditional treatment after a week of drug adjustments. As a therapeutic option, a Sympathetic Venous Blockade (SVB) with lidocaine was chosen, achieving a reduction in pain from 10 to 3 on the Visual Analog Scale. Infliximab was administered before discharge. The patient was re-evaluated at an outpatient appointment after 30 days.
CONCLUSION:
This strategy for the treatment of severe chest pain allowed for pain reduction and relief.
Keywords:
Case report; Chronic pain; Intractable pain; Lidocaine; Local anesthetics; Takayasu arteritis
HIGHLIGHTS
Patient with a rare disease, Takayasu’s arteritis, with symptoms of chest pain that were difficult to manage
Patient allergic to NSAIDs, considered standard treatment for chest pain. There was a need to use antidepressants, anticonvulsants and strong opioids, but the pain treatment failed;
Chest pain was relieved with intravenous lidocaine at a dose of 3 mg/kg for 2 hours, daily, until infliximab was used.