• Sunil Kumar, Sripal Bangalore, Ritu Kumari, Horiana Grosu, and Raymonde Jean.
• Department of Medicine, St. Luke's Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, New York 10019, USA.
• J Emerg Med. 2012 Nov 1;43(5):e311-4.

BackgroundAmiodarone use has been rarely associated with the development of acute respiratory distress syndrome (ARDS), usually in association with surgery or pulmonary angiography. In patients with preexisting left ventricular dysfunction, the diagnosis may be overlooked.Case ReportA 92-year-old woman with a history of atrial fibrillation who was on low-dose amiodarone presented to the Emergency Department with sudden onset of shortness of breath. The patient was started on treatment for acute heart failure based on the physical examination and the elevated brain natriuretic peptide level. Despite adequate diuresis, the patient showed no improvement. A chest computed tomography scan revealed acute interstitial pneumonitis. The patient received corticosteroids due to suspected amiodarone-induced acute interstitial pneumonitis resulting in ARDS. She returned to her baseline activity within 2 weeks of the therapy.ConclusionAlthough rare, clinicians should be vigilant for amiodarone-induced acute interstitial pneumonitis resulting in ARDS, as delay in treatment may result in a high risk of mortality. In addition, the development of ARDS occurred in our patient in the absence of precipitating factors such as surgery or pulmonary angiography.Copyright © 2012. Published by Elsevier Inc.

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