Document Detail

Pediatric myocardial infarction after racemic epinephrine administration.
MedLine Citation:
PMID:  10390295     Owner:  NLM     Status:  MEDLINE    
Myocardial infarction is a previously unreported complication of treatment with racemic epinephrine that is used commonly in the emergency department for severe respiratory distress in bronchiolitis or croup syndrome. We describe a pediatric patient who presented with the croup syndrome and severe respiratory distress that required multiple doses of nebulized racemic epinephrine in the emergency department. The patient developed ventricular tachycardia and mild chest discomfort during one treatment, which resolved spontaneously on discontinuation of the nebulization. Persistently abnormal electrocardiograms and elevated creatine phosphokinase MB isoenzyme (CPK-MB) levels suggested a myocardial infarction had occurred. Subsequent echocardiography, cardiac catheterization, and angiography revealed an anatomically normal heart with normal coronary circulation; however, a stress nuclear study showed a small myocardial infarct. The significance of this previously unreported complication of racemic epinephrine is discussed, along with recommendations for proper use in the emergency department.
M J Butte; B X Nguyen; T J Hutchison; J W Wiggins; J W Ziegler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  104     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-07-12     Completed Date:  1999-07-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  e9     Citation Subset:  IM    
Graduate Group in Biophysics, University of California San Francisco, San Francisco, California, USA.
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MeSH Terms
Croup / drug therapy*
Epinephrine / adverse effects*,  chemistry
Myocardial Infarction / chemically induced*
Reg. No./Substance:

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