title: Takotsubo Cardiomyopathy Due to Systemic Absorption of Intraocular Phenylephrine.
abstract: We present a case of Takotsubo cardiomyopathy (TTC) with regional variation in left ventricular function precipitated by intraocular injection of phenylephrine. To our knowledge, this is the first described case of TTC occurring in the setting of an intraocular medication. Contrary to the traditional model of the β2-receptor underlying the pathophysiology behind Takotsubo cardiomyopathy, phenylephrine is a pure α1-agonist implicating alternative mechanisms of myocardial injury resulting in a similar clinical phenotype. One should be alert to the possibility of catecholamine induced TTC occurring in patients subject to medications administered via the intraocular route with the potential for significant systemic absorption.
authors.affiliation: Liverpool Hospital, Sydney, NSW, Australia; Campbelltown Hospital, Sydney, NSW, Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Lee
authors.affiliation: Liverpool Hospital, Sydney, NSW, Australia; Campbelltown Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia; Western Sydney University, Sydney, NSW, Australia. Electronic address: ndtp@optusnet.com.au.
authors.forename: Phong
authors.initials: P
authors.lastname: Nguyen
mesh_terms: D058646:Adrenergic alpha-1 Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D008875:Middle Aged; D010656:Phenylephrine / Q000008:administration & dosage / Q000009:adverse effects*; D054549:Takotsubo Cardiomyopathy / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology
chemical_list: D058646:Adrenergic alpha-1 Receptor Agonists; D010656:Phenylephrine
keywords: Eye drops; Intraocular; Phenylephrine; Stress cardiomyopathy; Takotsubo