Document Detail


"Broken heart syndrome" after separation (from OxyContin).
MedLine Citation:
PMID:  16770984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe a 61-year-old woman with "broken heart syndrome" (Takotsubo-like cardiomyopathy) after abrupt postsurgical withdrawal of OxyContin. Her medical history was remarkable for long-term opiold dependence associated with the treatment of multi-Joint degenerative osteoarthritis. The patient presented to the emergency department 1 day after discharge from the hospital following total knee arthroplasty revision with acute-onset dyspnea and mild chest pain. She had precordial ST-segment elevation characteristic of acute myocardial infarction and elevated cardiac biomarkers. Emergency coronary angiography revealed no major coronary atherosclerosis. However, the left ventricular ejection fraction was severely decreased (26%), and new regional wall motion abnormalities typical of broken heart syndrome were noted. In addition to resuming her opioid therapy, she was treated supportively with bilevel positive airway pressure, diuretic therapy, morphine, aspirin, metoprolol, enalaprilat, intravenous heparin, nitroglycerin infusion, and dopamine infusion. Ventricular systolic function recovered completely by the fourth hospital day. To our knowledge, broken heart syndrome after opioid withdrawal has not been reported previously in an adult. Our case illustrates the importance of continuing adequate opiate therapy perioperatively in the increasing number of opioid-dependent patients to prevent potentially life-threatening complications such as broken heart syndrome.
Authors:
Juanita M Rivera; Adam J Locketz; Kevin D Fritz; Terese T Horlocker; David G Lewallen; Abhiram Prasad; John F Bresnahan; Michelle O Kinney
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  81     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-14     Completed Date:  2006-07-12     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  825-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / adverse effects*
Arthroplasty, Replacement, Knee
Cardiomyopathies / chemically induced*,  diagnosis
Female
Humans
Middle Aged
Osteoarthritis / drug therapy
Oxycodone / adverse effects*
Perioperative Care
Substance Withdrawal Syndrome* / diagnosis,  etiology
Syndrome
Ventricular Dysfunction, Left / chemically induced*,  diagnosis
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; CD35PMG570/Oxycodone
Comments/Corrections
Comment In:
Mayo Clin Proc. 2006 Jun;81(6):732-5   [PMID:  16770972 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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