Stress-induced cardiomyopathy following cephalosporin-induced anaphylactic shock during general anesthesia

Abstract

Transient, reversible left-ventricular dysfunction is a recently recognized phenomenon that may occur in the setting of anaphylactic reactions during the perioperative period.

Stress-induced cardiomyopathy in the perioperative setting

“…1 A prolonged period of profound hypotension was followed by appropriate resuscitative maneuvers, but the patient subsequently developed a cardiomyopathy requiring ongoing medical treatment. The authors highlight a rather unusual presentation of Tako-Tsubo cardiomyopathy which occurred in the perioperative setting.…”

“…The catecholamines temporarily disrupt the cardiac microvasculature resulting in myocardial dysfunction. In their report, Suk et al 1 infer that excess catecholamine surges may have occurred, either in response to the primary anaphylactic event or secondarily to the administration of exogenous epinephrine and norepinephrine given to treat the acute event.…”

Stress-induced Cardiomyopathy Complicated by Multiple Organ Failure Following Cephalosporin-induced Anaphylaxis

“…Stress-induced cardiomyopathy after antibiotic-induced anaphylaxis is uncommon, and only a few cases have been reported (12). Cepha- losporin anaphylaxis is rare, with a frequency of 0.0001-0.1% in the general population.…”

MRI documentation of Spontaneous Regression of lumbar disc herniation- A case report.

“…Furthermore, the rapid succession of the multiple medications often utilized for induction make it exquisitely difficult for the Anesthesiologist to identify any potential allergens that may trigger anaphylaxis. A review of the literature implicates induction agents, paralytics, opioids, local anesthetics, and antibiotics in instigating anaphylaxis, bronchospasm and subsequent pulmonary edema [27][28][29][30][31]. Though allergic reactions and anaphylaxis may present with cardiovascular collapse, skin erythema, swelling, and bronchospasm, these attributes are not mutually inclusive and often obscure attempts in arriving at a definitive diagnosis of the causative agent.…”