Key result
Inadvertent intravenous administration of 0.3 mg epinephrine for anaphylaxis caused reverse takotsubo cardiomyopathy with severe left ventricular systolic dysfunction that resolved within days.
Case Report (n=1)
No
This case highlights that iatrogenic epinephrine overdose can trigger reverse takotsubo cardiomyopathy, even in young men who do not fit the typical demographic profile.
Epinephrine overdose warrants consideration in acute LV dysfunction; this Level 5 case leaves open incidence, mechanisms, and prevention strategies.
Takotsubo cardiomyopathy is a syndrome characterized by transient left ventricular systolic and diastolic dysfunction, similar to an acute myocardial infarction but in the absence of significant obstructive epicardial coronary artery disease. This disease manifests predominantly in postmenopausal women in the presence of stressful triggers. We present a case of reverse takotsubo cardiomyopathy involving apical sparing, resulting from an iatrogenic overdose of epinephrine in a young man who was treated for anaphylaxis and angioedema.
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Bhat et al. (2019) conducted a case report in Reverse takotsubo cardiomyopathy (n=1). Epinephrine was evaluated on Development of reverse takotsubo cardiomyopathy. Inadvertent intravenous administration of 0.3 mg epinephrine for anaphylaxis caused reverse takotsubo cardiomyopathy with severe left ventricular systolic dysfunction that resolved within days.
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