Rare case of stress cardiomyopathy due to intramuscular epinephrine administration

BMJ Case Rep. 2016 Jun 7:2016:bcr2016215691. doi: 10.1136/bcr-2016-215691.

Abstract

We report a case of a 37-year-old woman who presented to our hospital with retrosternal chest pain following intramuscular administration of epinephrine due to presumed anaphylaxis. On arrival, she was found to have ST segment depression in the anterolateral leads on ECG and elevated cardiac troponins. She was diagnosed with stress cardiomyopathy based on left ventricle dysfunction and angiographically normal coronary arteries on cardiac catheterisation. To the best of our knowledge, this is the third reported case of takotsubo cardiomyopathy following appropriately dosed intramuscular administration of epinephrine for anaphylaxis. This case highlights the importance of considering stress cardiomyopathy in patients presenting with chest pain syndrome following systemic administration of epinephrine.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intranasal
  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Anaphylaxis / drug therapy
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Aspirin / therapeutic use
  • Echocardiography
  • Epinephrine / administration & dosage
  • Epinephrine / adverse effects*
  • Female
  • Humans
  • Rare Diseases / chemically induced
  • Takotsubo Cardiomyopathy / chemically induced*
  • Takotsubo Cardiomyopathy / diagnostic imaging
  • Takotsubo Cardiomyopathy / drug therapy

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Aspirin
  • Epinephrine