Atypical Chest Pain in a Patient With Breast Implant

Abstract

Breast implant surgery typically improves patient breast satisfaction and health-related quality of life. However, breast implants are also linked to long-term local problems like capsular contracture and breast discomfort. Chest pain is one of the reasons that patients with breast implants seek consultations, which is not typically attributable to cardiovascular reasons. The potential reasons for atypical chest pain are diverse. The absence of a precise diagnosis may also result in incorrect examinations and management, leading to further worry and wasted work time.A 55-year-old woman with a breast implant 10 years prior to the incident, presented with atypical chest pain on and off for a year and was treated as a case of unstable angina, costochondritis, and vasospastic spasm. Despite multiple visits, her symptoms did not resolve. Later, the patient presented with a lump over the left breast, associated with constitutional symptoms. Examination revealed a left breast implant with capsular contracture grade III, and ultrasonography showed signs of a ruptured implant. Symptoms eventually resolved after the removal of the breast implant.

Breast implant is associated with higher positive cardiac testing leading to a higher utilization of coronary angiography despite lower presence of coronary disease

“…Studies employing social media data have highlighted high rates of concern about breast implant-related illness, including cardiac illness (6). However, interference of breast implants with cardiac diagnostic procedures is not much debated despite the increasing utilization of these [procedures in women with advancing age, Furthermore, a higher prevalence of atypical presentation of cardiac ischemia in women is well documented which would increase higher utilization of diagnostic cardiac testing (7). Commonly used methods for identifying hemodynamically signi cant coronary artery disease are radionuclide myocardial perfusion imaging (MPI), single photon emission computed tomography (SPECT), and positron emission tomography (PET) (8).…”

Women with breast implants have a higher rate of cardiac catheterization but a lower rate of percutaneous coronary intervention suggesting breast implant interference leads to higher false positive rates of cardiac stress imaging

“…Studies employing social media data have highlighted high rates of concern about breast implant-related illness, including cardiac illness (6). However, interference of breast implants with cardiac diagnostic procedures is not much debated despite the increasing utilization of these [procedures in women with advancing age, Furthermore, a higher prevalence of atypical presentation of cardiac ischemia in women is well documented which would increase higher utilization of diagnostic cardiac testing (7). Commonly used methods for identifying hemodynamically significant coronary artery disease are radionuclide myocardial perfusion imaging (MPI), single photon emission computed tomography (SPECT), and positron emission tomography (PET) (8).…”