The presence of an acute coronary syndrome in patients with anaphylaxis is a challenging diagnostic conundrum for the cardiologist. Both Kounis syndrome and takotsubo syndrome must be taken into account. We present here the case of a 46-year-old woman suffering from ventricular fibrillation after adrenaline infusion for an anaphylactic reaction. The case report shows the important role of a clear diagnostic work-up and the role of cardiac magnetic resonance in this clinical scenario to reach the final diagnosis of reverse takotsubo cardiomyopathy.
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http://dx.doi.org/10.1714/2898.29219 | DOI Listing |
Am J Emerg Med
January 2025
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, South Korea.
Objectives: The recommended epinephrine administration interval during CPR is between 3 and 5 min. However, the optimal interval for improving cerebral perfusion remains controversial. This study aimed to evaluate the effects of epinephrine administration interval of 3 min or 5 min on cerebral perfusion pressure (CEPP) and cortical cerebral blood flow (CCBF) in a porcine cardiac arrest model.
View Article and Find Full Text PDFCureus
December 2024
Division of Dental Anesthesiology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, JPN.
Local anesthesia is a routine medical procedure for dentists. To achieve the desired anesthetic effect of lidocaine and favorable hemostatic effects by adrenaline, the combination of 2% lidocaine + 1:80,000 adrenaline is commonly used, including in dental patients with underlying diseases for whom adrenaline in local anesthetics is problematic due to its vasoconstrictive effects, as the adrenaline concentration in dental local anesthetic cartridges in Japan is commercially set at 1:80,000. To reduce the effect of adrenaline on the cardiovascular system, adrenaline is sometimes diluted in dental local anesthetic cartridges.
View Article and Find Full Text PDFCureus
December 2024
Department of Intensive Care Medicine, Centro Hospitalar Universitário de São João, Porto, PRT.
This case involves a 21-year-old male healthcare student with a medical history of HIV-1 infection for two years and anxiety disorder. He presented to the emergency department with hemoptysis and dyspnea of sudden onset. A thoracic CT scan revealed multiple bilateral nodular ground-glass opacities suggestive of diffuse alveolar hemorrhage (DAH).
View Article and Find Full Text PDFIntern Med
January 2025
Department of Respiratory Medicine, NHO Okayama Medical Center, Japan.
A 52-year-old Japanese man with a history of childhood asthma presented at our emergency department with progressive dyspnea. Despite subcutaneous adrenaline injections, salbutamol nebulization, and intravenous methylprednisolone, the carbon dioxide partial pressure (pCO) increased to 110 mmHg. The patient was intubated, and mechanical ventilation was initiated because of severe respiratory failure.
View Article and Find Full Text PDFJ Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Orthopaedic Surgery, Singapore General Hospital, Singapore (Dr. Loh, Dr. Ling, Dr. Jiang, and Lim) and the Department of Surgical Intensive Care, Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore (Dr. Goh).
We report a case of pulseless electrical activity (PEA) associated with profound hypermagnesemia immediately after cementation of a novel magnesium-based cement in spine surgery. During T8 to T12 posterior instrumentation and decompression laminectomy for vertebral metastasis secondary to lung cancer, a 61-year-old Chinese woman developed sudden hypotension and went into PEA immediately after injection of a novel magnesium-based cement. Intraoperative fluoroscopic imaging did not show any notable cement extravasation.
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