title: Apical ballooning syndrome following perioperative anaphylaxis is likely related to high doses of epinephrine.
abstract: Apical ballooning syndrome, a reversible left ventricle dysfunction, has been reported following anaphylaxis and, during this clinical circumstance, is seemingly linked to the use of either low or high doses of epinephrine. We report a severe succinylcholine-induced IgE-mediated anaphylaxis in a 65-year-old woman, in whom the diagnosis of apical ballooning syndrome following anaphylaxis was established. As a thorough description of the clinical features and resuscitative measures could be obtained, we discuss the reasons for apical ballooning syndrome occurrence and highlight the fact that optimal care management of anaphylaxis should include a progressive titration of epinephrine.
authors.affiliation: Service d'Anesthésie-Réanimation and SAMU de Paris, Université Paris-Descartes, INSERM UMRS-970 & Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, 149 Rue de Sèvres, 75743 Paris Cedex 15, France. pascale.dewachter@yahoo.fr
authors.forename: Pascale
authors.initials: P
authors.lastname: Dewachter
authors.forename: Claudia
authors.initials: C
authors.lastname: Tanase
authors.forename: Eric
authors.initials: E
authors.lastname: Levesque
authors.forename: Pascale
authors.initials: P
authors.lastname: Nicaise-Roland
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chollet-Martin
authors.forename: Claudie
authors.initials: C
authors.lastname: Mouton-Faivre
authors.forename: Dan
authors.initials: D
authors.lastname: Benhamou
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000150:complications* / Q000188:drug therapy; D004837:Epinephrine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D013390:Succinylcholine / Q000009:adverse effects*; D054549:Takotsubo Cardiomyopathy / Q000209:etiology*
chemical_list: D009467:Neuromuscular Depolarizing Agents; D007073:Immunoglobulin E; D013390:Succinylcholine; D004837:Epinephrine