title: [Acute latent myocarditis appearing with ventricular fibrillation after intranasal administration of adrenaline. Description of a case].
abstract: We report a case of a 17 year old sports woman, who had a ventricular fibrillation episode with cardiogenic shock during endonasal anaesthesia containing epinephrine. She was so transferred to our department (in shock): the 2-D echo showed biventricular hypokinesia without dilatation (LVEF less than 25%). Endomyocardial biopsy performed 5 days later showed active lymphocyte myocarditis with interstitial fibrosis. There were serum antibodies anti-Echo 9 and Coxsackie B 1, 2, 3. Immunoassay, urinary catecholamines and glucagon test were normal. The clinical picture was resolved within 15 days using intravenous isoprenaline and/or dopamine initially followed by oral diuretics and digoxin; the therapy was broke off at the time of discharge. We believe that the vasoconstriction and/or the oxygen wasting effect caused by epinephrine revealed latent myocarditis which had not been shown up even by intensive physical training.
authors.forename: C
authors.initials: C
authors.lastname: Tamburino
authors.forename: E
authors.initials: E
authors.lastname: Salomone
authors.forename: G
authors.initials: G
authors.lastname: Russo
authors.forename: B
authors.initials: B
authors.lastname: Panascia
authors.forename: L
authors.initials: L
authors.lastname: Malatino
authors.forename: V
authors.initials: V
authors.lastname: Calvi
authors.forename: G
authors.initials: G
authors.lastname: Giuffrida
mesh_terms: D000293:Adolescent; D000769:Anesthesia, Inhalation; D001706:Biopsy; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000150:complications* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D014693:Ventricular Fibrillation / Q000209:etiology*
chemical_list: D004837:Epinephrine
vernacular_title: Miocardite acuta latente esordita con fibrillazione ventricolare dopo infiltrazione endonasale di adrenalina. Descrizione di un caso.