[Acute latent myocarditis appearing with ventricular fibrillation after intranasal administration of adrenaline. Description of a case]

Cardiologia. 1989 Sep;34(9):803-6.
[Article in Italian]

Abstract

We report a case of a 17 year old sports woman, who had a ventricular fibrillation episode with cardiogenic shock during endonasal anaesthesia containing epinephrine. She was so transferred to our department (in shock): the 2-D echo showed biventricular hypokinesia without dilatation (LVEF less than 25%). Endomyocardial biopsy performed 5 days later showed active lymphocyte myocarditis with interstitial fibrosis. There were serum antibodies anti-Echo 9 and Coxsackie B 1, 2, 3. Immunoassay, urinary catecholamines and glucagon test were normal. The clinical picture was resolved within 15 days using intravenous isoprenaline and/or dopamine initially followed by oral diuretics and digoxin; the therapy was broke off at the time of discharge. We believe that the vasoconstriction and/or the oxygen wasting effect caused by epinephrine revealed latent myocarditis which had not been shown up even by intensive physical training.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Anesthesia, Inhalation
  • Biopsy
  • Epinephrine / administration & dosage*
  • Female
  • Humans
  • Myocarditis / complications*
  • Myocarditis / pathology
  • Myocardium / pathology
  • Ventricular Fibrillation / etiology*

Substances

  • Epinephrine