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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...

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Autores principales: Cronin, Michael, Moradi, Dena, Cotter, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
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.
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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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