Key result
Multimodal monitoring and bedside echocardiography successfully guide resuscitation in a case of tizanidine-induced cardiogenic shock.
Why the study?
Literature recognizing tizanidine-induced reversible heart failure is sparse, and data on advanced shock resuscitation in forward-deployed military environments are limited.
Case Report (n=1)
No
This case demonstrates the feasibility of using multimodal hemodynamic monitoring and bedside echocardiography to successfully manage tizanidine-induced cardiogenic shock in a resource-limited, forward-deployed setting.
Tizanidine may trigger reversible cardiogenic shock; single case leaves open its cardiotoxicity profile and monitoring strategies.
We report a 58-year-old Active-Duty male who developed transient, severe left ventricular dysfunction with cardiogenic shock after tizanidine ingestion, successfully managed in a forward-deployed Role 3 U.S. Army Field Hospital. This case highlights the use of multimodal macro- and micro-hemodynamic monitoring-capillary refill time, urine output, lactate, central venous oxygen saturation (ScvO2), and bedside echocardiography-to guide titration of vasoactive medications when right heart/pulmonary artery catheterization was unavailable. Echocardiography was applied both qualitatively (visual ejection fraction assessment) and quantitatively (stroke volume and cardiac output estimation via left-ventricular outflow tract [LVOT] diameter and velocity-time integral [VTI]). Despite profound left ventricular dysfunction and multi-drug hemodynamic dependence, cardiac function quickly normalized. This case demonstrates that advanced, physiology-guided shock resuscitation is feasible in trauma-focused, forward-deployed environments and adds to the sparse literature recognizing tizanidine-induced, reversible heart failure.
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Hutto et al. (2026) conducted a case report in Tizanidine-induced cardiogenic shock (n=1). Multimodal hemodynamic monitoring and bedside echocardiography was evaluated. Multimodal hemodynamic monitoring and bedside echocardiography successfully guided resuscitation in a patient with tizanidine-induced cardiogenic shock, resulting in normalized cardiac function.
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