[Acute latent myocarditis appearing with ventricular fibrillation after intranasal administration of adrenaline. Description of a case].
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.
Tamburino
C
C
Salomone
E
E
Russo
G
G
Panascia
B
B
Malatino
L
L
Calvi
V
V
Giuffrida
G
G
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*
D004837:Epinephrine
Miocardite acuta latente esordita con fibrillazione ventricolare dopo infiltrazione endonasale di adrenalina. Descrizione di un caso.