Reverse Takotsubo Cardiomyopathy in the Setting of Anaphylaxis Treated with High-dose Intravenous Epinephrine

Myocardial edema as a substrate of electrocardiographic abnormalities and life-threatening arrhythmias in reversible ventricular dysfunction of takotsubo cardiomyopathy: Imaging evidence, presumed mechanisms, and implications for therapy

“…1,2 This syndrome usually affects postmenopausal women and is precipitated by physical stress, psychological triggers, or other states of adrenergic overstimulation such as administration of catecholamines, abrupt withdrawal of psychotropic drugs, and uncontrolled pain. [3][4][5][6] Affected patients usually survive, showing restoration of previous cardiovascular status with electrocardiographic (ECG) normalization and recovery of ventricular function within approximately 1 month. 1 Based on the regional distribution of LV dysfunction, the following variants of TTC have been described: 1 "typical" (akinesia of the mid-apical LV segments) and 3 "atypical," that is, "mid-ventricular" (akinesia of the mid-LV segments), "reverse" (wall motion abnormalities confined to the basal/ mid LV segments), and "localized" to specific LV areas.…”

Is Cardiomyopathy Associated with Peripartum or Anaphylactic Reaction? Which One?

“…In literature, there are rare case reports about cardiomyopathy following epinephrine administration for anaphylaxisbut, no evidence of anaphylactic or epinephrine administration that may be the cause of PPCM was observed [4,5]. In our case, anaphylactic reaction treated with epinephrine due to blood transfusion mayconsidered as a reason of cardiomyopathy.…”

“…Rare cases have been reported in the literature about cardiomyopathy in the setting of anaphylaxis treated with epinephrine [4,5]. But PPCM, which may be associated with anaphylaxis and epinephrine administration, has never been reported.…”

A case of takotsubo cardiomyopathy in a patient with anaphylaxis treated with epinephrine

“…[2] Stress cardiomyopathy has also been reported in patients with anaphylaxis treated with aggressive epinephrine therapy, as well as patients with phaeochromocytoma. [3,4] Most of these cases have been associated with high doses of epinephrine. American Heart Association guidelines recommends a 0.3 mg intramuscular or 0.1 mg intravenous dose of epinephrine for anaphylaxis.…”