title: The importance of amiodarone pulmonary toxicity in the differential diagnosis of a patient with dyspnea awaiting a heart transplant.
abstract: 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.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP.
authors.forename: Christiano Pereira
authors.initials: CP
authors.lastname: Silva
authors.forename: Fernando
authors.initials: F
authors.lastname: Bacal
authors.forename: Philippe Vieira
authors.initials: PV
authors.lastname: Pires
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Drager
authors.forename: Germano Emílio Conceição
authors.initials: GE
authors.lastname: Souza
authors.forename: Ginny Michele G
authors.initials: GM
authors.lastname: Fajardo
authors.forename: Léa Maria Macruz F
authors.initials: LM
authors.lastname: Demarchi
authors.forename: Edimar Alcides
authors.initials: EA
authors.lastname: Bocchi
mesh_terms: 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
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone