title: Myocardial ischaemia following cocaine and adrenaline exposure in a child during an ophthalmological procedure.
abstract: We report a 23-month old girl who presented with bilateral epiphora who underwent bilateral lacrimal probing and syringing, during which a cocaine adrenaline solution was used. Two hours after the procedure she developed acute pulmonary oedema secondary to myocardial ischaemia. The patient was treated with intravenous glyceryltrinitrate and milrinone infusions; cardiac enzymes and left ventricular function normalised over the subsequent 72 hours. Topical administration of cocaine and adrenaline solution may have dangerous systemic cardiac effects and should always be used judiciously.
authors: E
authors: E
authors: McGovern
authors: E
authors: E
authors: Moylett
authors: C J
authors: CJ
authors: McMahon
mesh_terms: D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000008:administration & dosage; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D003941:Diagnostic Techniques, Ophthalmological; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000628:therapy; D020105:Milrinone / Q000008:administration & dosage*; D009184:Mydriatics / Q000008:administration & dosage / Q000009:adverse effects; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000628:therapy; D005996:Nitroglycerin / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D002317:Cardiovascular Agents; D009184:Mydriatics; D005996:Nitroglycerin; D003042:Cocaine; D020105:Milrinone; D004837:Epinephrine