Cardiac arrest following intravenous administration of metaraminol in Takotsubo cardiomyopathy

Abstract

A sixty-year-old female presented to the emergency department with a perforated duodenal ulcer. Whilst awaiting surgery she developed chest pain and ST segment changes consistent with an inferior myocardial infarction. It was considered necessary to continue with surgical management, however general anaesthesia was complicated postoperatively by an episode of pulseless ventricular tachycardia, that appeared to be triggered by intravenous metaraminol. Subsequent coronary angiography demonstrated no evidence of coronary artery disease but findings were suggestive of Takotsubo cardiomyopathy, which was probably exacerbated by intravenous metaraminol.