Key result
Ketamine and epinephrine for status asthmaticus linked to iatrogenic takotsubo syndrome requiring hemodynamic support.
Why the study?
Iatrogenic takotsubo syndrome induced by vasoactive agents during treatment of status asthmaticus requires recognition due to its mimicry of acute myocardial infarction.
Case Report (n=1)
Vasoactive agents like ketamine and epinephrine used for status asthmaticus can precipitate iatrogenic takotsubo syndrome, which should be suspected in acute left ventricular dysfunction without coronary artery disease.
Answers are grounded in this paper and cite their sources.
Potential iatrogenic takotsubo from ketamine/epinephrine in status asthmaticus merits vigilance; single case leaves causal link unproven.
Broken heart syndrome, otherwise known as takotsubo syndrome, is stress-induced cardiomyopathy. Clinical presentation mimics acute ST segment elevation myocardial infarction, but with characteristic left ventricular apical ballooning. The mechanism is linked to overstimulation of the sympathetic system from high circulating catecholamine levels. We report a 46-year-old Caucasian female whose treatment of status asthmaticus with ketamine and epinephrine precipitated this syndrome. She required hemodynamic support with an intra-aortic balloon pump and dobutamine infusion. Myocardial function improved dramatically with supportive treatment. Iatrogenically induced takotsubo syndrome with vasoactive agents should be suspected in acute left ventricular dysfunction without coronary artery disease.
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Osuorji et al. (2009) conducted a case report in Status asthmaticus and Takotsubo syndrome (n=1). Ketamine and epinephrine was evaluated on Development of takotsubo syndrome. Treatment of status asthmaticus with ketamine and epinephrine precipitated iatrogenically induced takotsubo syndrome requiring hemodynamic support in a 46-year-old female.
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