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Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy
Intramuscular adrenaline is a standard treatment approach for the symptomatic patient presenting with distress and oropharyngeal edema, requiring subsequent doses if oedema persists. This case demonstrates a delayed side-effect of stress-induced cardiomyopathy after adrenaline administration. A 62-y...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603774/ https://www.ncbi.nlm.nih.gov/pubmed/34900557 http://dx.doi.org/10.4103/jcecho.jcecho_40_21 |
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author | Cronin, Michael Moradi, Dena Cotter, Paul |
author_facet | Cronin, Michael Moradi, Dena Cotter, Paul |
author_sort | Cronin, Michael |
collection | PubMed |
description | Intramuscular adrenaline is a standard treatment approach for the symptomatic patient presenting with distress and oropharyngeal edema, requiring subsequent doses if oedema persists. This case demonstrates a delayed side-effect of stress-induced cardiomyopathy after adrenaline administration. A 62-year-old suffered acute oropharyngeal angioedema secondary to angiotensin-converting-enzyme inhibitor use. Two standard doses of intramuscular adrenaline 2 hours apart were administered, and she was monitored for 2 days. On day three post discharge, she represented with acute hypervolaemia. Transthoracic echocardiogram showed a globally dilated, poorly functioning left ventricle. Cardiac magnetic resonance imaging described takotsubo cardiomyopathy. One month later, left ventricular function had normalised with optimal medical treatment. Cardiomyopathy with a temporal relationship to a hypersensitivity reaction is thought to occur due to one of three mechanisms: Stress (takotsubo) cardiomyopathy, allergic acute coronary (Kounis) Syndrome, and hypersensitive myocarditis. If a clinical presentation of hypersensitivity is such that it requires treatment with epinephrine, it is particularly challenging to determine the exact cause of cardiomyopathy. |
format | Online Article Text |
id | pubmed-8603774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-86037742021-12-10 Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy Cronin, Michael Moradi, Dena Cotter, Paul J Cardiovasc Echogr Case Report Intramuscular adrenaline is a standard treatment approach for the symptomatic patient presenting with distress and oropharyngeal edema, requiring subsequent doses if oedema persists. This case demonstrates a delayed side-effect of stress-induced cardiomyopathy after adrenaline administration. A 62-year-old suffered acute oropharyngeal angioedema secondary to angiotensin-converting-enzyme inhibitor use. Two standard doses of intramuscular adrenaline 2 hours apart were administered, and she was monitored for 2 days. On day three post discharge, she represented with acute hypervolaemia. Transthoracic echocardiogram showed a globally dilated, poorly functioning left ventricle. Cardiac magnetic resonance imaging described takotsubo cardiomyopathy. One month later, left ventricular function had normalised with optimal medical treatment. Cardiomyopathy with a temporal relationship to a hypersensitivity reaction is thought to occur due to one of three mechanisms: Stress (takotsubo) cardiomyopathy, allergic acute coronary (Kounis) Syndrome, and hypersensitive myocarditis. If a clinical presentation of hypersensitivity is such that it requires treatment with epinephrine, it is particularly challenging to determine the exact cause of cardiomyopathy. Wolters Kluwer - Medknow 2021 2021-10-26 /pmc/articles/PMC8603774/ /pubmed/34900557 http://dx.doi.org/10.4103/jcecho.jcecho_40_21 Text en Copyright: © 2021 Journal of Cardiovascular Echography https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Cronin, Michael Moradi, Dena Cotter, Paul Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy |
title | Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy |
title_full | Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy |
title_fullStr | Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy |
title_full_unstemmed | Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy |
title_short | Angiotensin-Converting Enzyme Inhibitor-Induced Oropharyngeal edema with Subsequent Stress-Cardiomyopathy |
title_sort | angiotensin-converting enzyme inhibitor-induced oropharyngeal edema with subsequent stress-cardiomyopathy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8603774/ https://www.ncbi.nlm.nih.gov/pubmed/34900557 http://dx.doi.org/10.4103/jcecho.jcecho_40_21 |
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