A Case of Reversible Catecholamine Induced Cardiomyopathy by Retrobulbar Epinephrine Injection

ABSTRACT

Catecholamine induced cardiomyopathy is well known in pheochromocytoma, subarachnoid hemorrhage patients and in patients who received with large amount of exogenous catecholamine for therapeutic use. Few cases have been reported after short time exposure of excessive exogenous catecholamine. Furthermore only one case has been reported after clinically relevant dose of exogenous catecholamine in Japan. We describe a 38-year-old female presented as chest pain and presyncope after retrobulbar injection of a small dose epinephrine for opthalmologic surgery. The echocardiography and the cardiac specific enzyme of her demonstrated cardiomyopathy. Her cardiac funcion was nearly normalized after dopamine and dobutamine therapy. We report a case of cardiomyopathy induced by a clinical acceptable dose of retrobulbar epinephrine injection in a patient with no evidence of heart disease.