[Acute myocardial infarction triggered by salbutamol in asthma bronchiale].
The authors report the case of an 77-year-old woman with no evidence of previous cardiac disease who developed a non-Q-wave myocardial infarction after beta2-mimetic treatment for the exacerbation of her chronic bronchial asthma. After the five dose of salbutamol spray she developed chest pain. The electrogram showed ST segment elevation in leads I-aVL-V4-6. Urgent coronary angiography showed only non significant left anterior coronary artery stenosis (20%). A subsequent echocardiogram also revealed anterolateral hypokinesia and acute reversible left ventricular dysfunction (LVEF:30%). Both troponin T concentration and creatine kinase rose. Next day in the lateral leads negative T-waves developed with QT-prolongation and without pathologic Q-waves. Although myocardial infarction and acute reversible left ventricular dysfunction is a rare complication following beta2 mimetic treatment one should use high-dose beta2-agonists with caution.
Tomcsányi
János
J
Budai Irgalmasrendi Kórház Kardiológia, Budapest. tomcsanyi.janos@axelero.hu
Somlói
Miklós
M
Frész
Tamás
T
Arabadzisz
Hrisula
H
Zsoldos
András
A
Vecsey
Tibor
T
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000503:physiopathology
D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D000420:Albuterol