Acute myocardial infarction after administration of low-dose intravenous epinephrine for anaphylaxis.
This case describes a 29-year-old woman who presented with an acute severe anaphylactic reaction to penicillin. In addition to other medications administered in the emergency department, she received 0.1 mg intravenously of 1:10 000 epinephrine, after which she immediately developed severe chest pain. Her ECG showed ST elevations consistent with an anterior myocardial infarction, and her serum troponin level was elevated. A CT angiogram showed no signs of coronary artery disease or abnormal anatomy. This case is an example of vasospasm-induced myocardial injury and illustrates a potential danger of intravenous epinephrine use. The authors were able to identify only 2 other case reports where therapeutic doses of epinephrine have been reported to cause this phenomenon.
Shaver
Kyle J
KJ
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico 87131-0001, USA.
Adams
Christopher
C
Weiss
Steven J
SJ
D000208:Acute Disease; D000322:Adrenergic Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced / Q000188:drug therapy*; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D009203:Myocardial Infarction / Q000139:chemically induced*; D010406:Penicillins / Q000009:adverse effects
D000322:Adrenergic Agonists; D010406:Penicillins; D004837:Epinephrine