• Can J Emerg Med · Jul 2006

    Case Reports

    Acute myocardial infarction after administration of low-dose intravenous epinephrine for anaphylaxis.

    • Kyle J Shaver, Christopher Adams, and Steven J Weiss.
    • Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico 87131-0001, USA.
    • Can J Emerg Med. 2006 Jul 1;8(4):289-94.

    AbstractThis case describes a 29-year-old woman who presented with an acute severe anaphylactic reaction to penicillin. In addition to other medications administered in the emergency department, she received 0.1 mg intravenously of 1:10 000 epinephrine, after which she immediately developed severe chest pain. Her ECG showed ST elevations consistent with an anterior myocardial infarction, and her serum troponin level was elevated. A CT angiogram showed no signs of coronary artery disease or abnormal anatomy. This case is an example of vasospasm-induced myocardial injury and illustrates a potential danger of intravenous epinephrine use. The authors were able to identify only 2 other case reports where therapeutic doses of epinephrine have been reported to cause this phenomenon.

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