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Acute myocardial infarction after administration of low-dose intravenous epinephrine for anaphylaxis

Published online by Cambridge University Press:  21 May 2015

Kyle J. Shaver
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
Christopher Adams
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
Steven J. Weiss*
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
*
University of New Mexico, MSC 10 5560, 1 University of New Mexico, Albuquerque NM 87131-0001

Abstract

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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.

Type
Case Report • Observations de cas
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

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