Intramuscular Epinephrine-Induced Transient ST-Elevation Myocardial Infarction

Introduction. Myocardial infarction in the setting of anaphylaxis may result from the anaphylaxis itself or from the epinephrine used to treat the anaphylaxis. While cases of myocardial infarction due to large doses of intravenous epinephrine have previously been reported, myocardial infarction afte...

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Bibliographic Details
Published in:JIM - high impact case reports 2018-01, Vol.6, p.2324709618785651-2324709618785651
Main Authors: Shrestha, Binav, Kafle, Paritosh, Thapa, Shivani, Dahal, Suyash, Gayam, Vijay, Dufresne, Alix
Format: Article
Language:English
Subjects:
Anaphylaxis
Case Report
Case reports
Electrocardiography
Heart attacks
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Summary:Introduction. Myocardial infarction in the setting of anaphylaxis may result from the anaphylaxis itself or from the epinephrine used to treat the anaphylaxis. While cases of myocardial infarction due to large doses of intravenous epinephrine have previously been reported, myocardial infarction after therapeutic doses of intramuscular epinephrine is rarely reported. Case Report. A 23-year-old male presented with sudden onset of difficulty in swallowing and speech after eating takeout food. He was treated with intramuscular epinephrine for presumed angioedema following which he immediately developed chest tightness associated with ST elevation on electrocardiogram and elevated serum troponin. His symptoms and electrocardiogram findings were transient and resolved within the next 10 minutes. Conclusion. Epinephrine is lifesaving during anaphylaxis and should be promptly used. Health care providers, however, need to be aware and vigilant of this rare complication of epinephrine.
ISSN:2324-7096
2324-7096
DOI:10.1177/2324709618785651