Pediatric myocardial infarction after racemic epinephrine administration.
نویسندگان
چکیده
Myocardial infarction is a previously unreported complication of treatment with racemic epinephrine that is used commonly in the emergency department for severe respiratory distress in bronchiolitis or croup syndrome. We describe a pediatric patient who presented with the croup syndrome and severe respiratory distress that required multiple doses of nebulized racemic epinephrine in the emergency department. The patient developed ventricular tachycardia and mild chest discomfort during one treatment, which resolved spontaneously on discontinuation of the nebulization. Persistently abnormal electrocardiograms and elevated creatine phosphokinase MB isoenzyme (CPK-MB) levels suggested a myocardial infarction had occurred. Subsequent echocardiography, cardiac catheterization, and angiography revealed an anatomically normal heart with normal coronary circulation; however, a stress nuclear study showed a small myocardial infarct. The significance of this previously unreported complication of racemic epinephrine is discussed, along with recommendations for proper use in the emergency department.
منابع مشابه
Anti-streptokinase Antibody Detection before and Immediately after Streptokinase Therapy in Patients with Myocardial Infarction
Background: Myocardial infarction (MI) is one of the most common and serious diseases resulting from coronary artery occlusion and major reduction in blood flow. Streptokinase as a thrombolytic is considered the first and most important therapeutic intervention for reperfusion following MI in most countries including Iran. Our previous study showed that, the prevalence of high antibody titers a...
متن کاملAcute myocardial infarction after administration of low-dose intravenous epinephrine for anaphylaxis.
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 ...
متن کاملNebulizatin Methylprednisolone, Racemic Epinephrine and Lidocaine in minor Pediatric Laryngeal Surgery By
Objectives: The main objectives of anesthesia for laryngeal surgery are to provide immobile field, enough space for the rigid laryngoscope, secured airway and ventilation, hemodynamic stability and of the same importance is the uneventful recovery (suggest to cancel) . The aim of this study is to compare the effects of three different drugs given by nebulizing techniques. We compared methylpred...
متن کاملPrediction of long-term cardiac events by 123I-MIBG imaging after acute myocardial infarction and reperfusion therapy
Objective(s): In heart failure, the heart-to-mediastinum (H/M) ratio of the delayed image and washout rate (WR) are well-known as a powerful cardiac event predictors. H/M ratio quantifies the accumulation rate of MIBG in the myocardium and WR quantifies reduction of meta-iodobenzylguanidine (MIBG) accumulation in the heart from the early planar image to the delayed pla...
متن کاملA randomized comparison of helium-oxygen mixture (Heliox) and racemic epinephrine for the treatment of moderate to severe croup.
OBJECTIVE To compare the additive effect of a helium-oxygen mixture (Heliox) or racemic epinephrine (RE) on croup scores (CSs) in children with moderate to severe croup treated with humidified oxygen and steroids. Design. A prospective, randomized, double-blind trial. SETTING Emergency department and pediatric intensive care unit of an urban level I trauma center. PARTICIPANTS Randomly assi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Pediatrics
دوره 104 1 شماره
صفحات -
تاریخ انتشار 1999