Myocardial stunning secondary to erroneous administration of intravenous epinephrine
Epinephrine is a commonly used medication for emergent conditions, such as anaphylaxis, respiratory distress, and shock. However, its versatility can also lead to iatrogenic errors in dosages, concentrations, and routes of administration. In this case, a 47-year-old female experiencing anaphylaxis r...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-03-01
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| Series: | SAGE Open Medical Case Reports |
| Online Access: | https://doi.org/10.1177/2050313X231159732 |
| _version_ | 1827988753474387968 |
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| author | Girish Pathangey Rohitha Moudgal Christopher Lee Stanislav Henkin |
| author_facet | Girish Pathangey Rohitha Moudgal Christopher Lee Stanislav Henkin |
| author_sort | Girish Pathangey |
| collection | DOAJ |
| description | Epinephrine is a commonly used medication for emergent conditions, such as anaphylaxis, respiratory distress, and shock. However, its versatility can also lead to iatrogenic errors in dosages, concentrations, and routes of administration. In this case, a 47-year-old female experiencing anaphylaxis received an intravenous dose of 0.3 mg (1:1000) epinephrine formulated for intramuscular injection, resulting in cardiac arrest and acute heart failure due to myocardial stunning, as diagnosed by echocardiography. Management included invasive ventilation and hemodynamic support until cardiac function recovered. This case highlights the potential dangers of epinephrine overdose, and to our knowledge, is the first reported case of iatrogenic epinephrine-induced Takotsubo cardiomyopathy in a rural area. In addition, we review the literature on iatrogenic epinephrine toxicity-associated cardiomyopathy and the epidemiology of epinephrine errors. Safety measures must be considered for improving communication in emergencies, increasing awareness via training, and changing epinephrine’s antiquated packaging design. |
| first_indexed | 2024-04-10T00:08:17Z |
| format | Article |
| id | doaj.art-df4734829b344f1cb19183a1c7775401 |
| institution | Directory Open Access Journal |
| issn | 2050-313X |
| language | English |
| last_indexed | 2024-04-10T00:08:17Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medical Case Reports |
| spelling | doaj.art-df4734829b344f1cb19183a1c77754012023-03-16T18:03:39ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2023-03-011110.1177/2050313X231159732Myocardial stunning secondary to erroneous administration of intravenous epinephrineGirish Pathangey0Rohitha Moudgal1Christopher Lee2Stanislav Henkin3Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USADepartment of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USAHeart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USAHeart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USAEpinephrine is a commonly used medication for emergent conditions, such as anaphylaxis, respiratory distress, and shock. However, its versatility can also lead to iatrogenic errors in dosages, concentrations, and routes of administration. In this case, a 47-year-old female experiencing anaphylaxis received an intravenous dose of 0.3 mg (1:1000) epinephrine formulated for intramuscular injection, resulting in cardiac arrest and acute heart failure due to myocardial stunning, as diagnosed by echocardiography. Management included invasive ventilation and hemodynamic support until cardiac function recovered. This case highlights the potential dangers of epinephrine overdose, and to our knowledge, is the first reported case of iatrogenic epinephrine-induced Takotsubo cardiomyopathy in a rural area. In addition, we review the literature on iatrogenic epinephrine toxicity-associated cardiomyopathy and the epidemiology of epinephrine errors. Safety measures must be considered for improving communication in emergencies, increasing awareness via training, and changing epinephrine’s antiquated packaging design.https://doi.org/10.1177/2050313X231159732 |
| spellingShingle | Girish Pathangey Rohitha Moudgal Christopher Lee Stanislav Henkin Myocardial stunning secondary to erroneous administration of intravenous epinephrine SAGE Open Medical Case Reports |
| title | Myocardial stunning secondary to erroneous administration of intravenous epinephrine |
| title_full | Myocardial stunning secondary to erroneous administration of intravenous epinephrine |
| title_fullStr | Myocardial stunning secondary to erroneous administration of intravenous epinephrine |
| title_full_unstemmed | Myocardial stunning secondary to erroneous administration of intravenous epinephrine |
| title_short | Myocardial stunning secondary to erroneous administration of intravenous epinephrine |
| title_sort | myocardial stunning secondary to erroneous administration of intravenous epinephrine |
| url | https://doi.org/10.1177/2050313X231159732 |
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