The importance of amiodarone pulmonary toxicity in the differential diagnosis of a patient with dyspnea awaiting a heart transplant.
Amiodarone is a class III antiarrhythmic medication used extensively to treat ventricular arrhythmias. It is pharmacologically classified as a cationic amphiphilic drug due to its polar and apolar components. During the past few years, amiodarone has proved to be an effective treatment therapy for patients with ventricular dysfunctions, regardless of the etiology, and in particular ventricular arrhythmia associated with Chagas disease. Nevertheless, despite its hemodynamic and electrophysiological benefits, amiodarone produces serious collateral effects such as a bluish skin discoloration, photosensitivity, thyroid dysfunction, corneal deposit, peripheral neuropathy, bone marrow suppression, hepatitis, heart blocks, pneumonitis, among others. The objective of this case report is to discuss one of the most serious complications related to amiodarone, pulmonary toxicity, which is described as a differential diagnosis for a chagasic patient that was on the waiting list for a heart transplant. Amiodarone pneumonitis is a relevant differential diagnosis for heart failure (HF) patients using amiodarone that are admitted to the emergency ward with dyspnea.
Silva
Christiano Pereira
CP
Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP.
Bacal
Fernando
F
Pires
Philippe Vieira
PV
Drager
Luciano F
LF
Souza
Germano Emílio Conceição
GE
Fajardo
Ginny Michele G
GM
Demarchi
Léa Maria Macruz F
LM
Bocchi
Edimar Alcides
EA
D000328:Adult; D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology*; D006333:Heart Failure / Q000188:drug therapy / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone