This case highlights the diagnostic challenge of differentiating pulmonary edema from acute amiodarone-induced pulmonary toxicity and demonstrates rapid clinical improvement following drug discontinuation and steroid therapy.
May warrant amiodarone toxicity consideration in post-initiation respiratory failure; single case leaves open prospective diagnostic validation.
This case report describes a 68-year-old man who developed acute hypoxic respiratory failure 2 weeks after initiation of amiodarone and mexiletine treatment for ventricular arrhythmia. The case underscores the diagnostic challenge of differentiating pulmonary edema from acute amiodarone-induced pulmonary toxicity and the importance of clinical context when interpreting imaging findings. Management involved immediate discontinuation of amiodarone and initiation of high-dose intravenous steroids followed by a prolonged oral taper, resulting in rapid clinical improvement. This case further illustrates the potential for oral amiodarone to cause multiorgan toxicity.
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