Subject(s)
Aspirin/adverse effects , Drug Resistance , Ecchymosis/diagnosis , Ecchymosis/etiology , Platelet Aggregation Inhibitors/adverse effects , Aspirin/therapeutic use , Biomarkers , Cardiovascular Diseases/drug therapy , Humans , Platelet Aggregation Inhibitors/therapeutic use , Treatment FailureABSTRACT
BACKGROUND: Takotsubo cardiomyopathy is seen, though rarely, in anaphylaxis treated with epinephrine. Stress cardiomyopathy is most likely to occur in middle-aged women. The underlying etiology is believed to be related to catecholamine release in periods of intense stress. Catecholamines administered exogenously, and those secreted by neuroendocrine tumors (e.g., pheochromocytoma) or during anaphylaxis have been reported to cause apical ballooning syndrome, or takotsubo syndrome. However, reverse takotsubo stress cardiomyopathy is rarely seen or reported in anaphylaxis treated with epinephrine. OBJECTIVES: To report a case illustrating that high-dose intravenous epinephrine can trigger stress cardiomyopathy, and that the risk is heightened with inappropriate dosing in the treatment of anaphylaxis. CASE REPORT: We report a rare case of iatrogenic reverse takotsubo syndrome in a young woman who was inappropriately treated with high-dose intravenous epinephrine for mild anaphylaxis. CONCLUSION: Inappropriately high doses of intravenous epinephrine can trigger stress cardiomyopathy. Emergency physicians should be familiar with the diagnosis, grading, and appropriate treatments of anaphylaxis to avoid this unnecessary complication.
Subject(s)
Adrenergic alpha-Agonists/adverse effects , Anaphylaxis/drug therapy , Epinephrine/adverse effects , Takotsubo Cardiomyopathy/chemically induced , Acute Coronary Syndrome/diagnosis , Administration, Intravenous , Adrenergic alpha-Agonists/administration & dosage , Adult , Diagnosis, Differential , Epinephrine/administration & dosage , Female , Humans , Takotsubo Cardiomyopathy/diagnosisABSTRACT
Hemolytic anemia is a known complication after valve replacement, but the incidence of hemolysis following valve repair is unknown. A case involving mitral annuloplasty complicated by hemolytic anemia, which resolved after replacement of the valve, is presented. Only 70 cases of hemolysis after mitral valve repair have been reported in the literature. In nearly all of these cases, replacement or rerepair of the valve was the definitive treatment for hemolysis.
ABSTRACT
It is becoming more evident that age, gender, and race play a significant role in the metabolic profiles that are seen among individuals in a clinical setting. It is important to understand these variances in metabolic profiles; and with these variances in mind it is now possible to understand why a single diet might not decrease cardiovascular disease risk profiles uniformly for everyone. Much is now understood about triglyceride metabolism and its contribution to energy storage. In this review we will focus on triglycerides; their production, metabolism and influence on daily life, as well as the various methods for the treatment of hypertryglyceridemia and prevention of its sequelae.
