Department of Cardiology, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, Lancashire, UK.
Am J Emerg Med. 2013 Apr;31(4):759.e1-2. doi: 10.1016/j.ajem.2012.11.022. Epub 2013 Feb 4.
Epinephrine-induced myocardial ischemia in the setting of anaphylaxis is a rare event and is postulated to be due to coronary artery spasm. We report the case of a 43-year-old woman who presented to the emergency department with an anaphylactic reaction triggered by flucloxacillin. She was treated with intramuscular epinephrine, following which she developed ischemic chest pain and electrocardiographic changes, associated with troponin elevation. Subsequent coronary angiography demonstrated normal coronary arteries. In this case report, we discuss the potential role of prior nonselective β-blockade with propranolol in predisposing such patients to ischemic cardiac events following treatment with epinephrine.
在过敏反应的情况下，肾上腺素引起的心肌缺血是一种罕见的事件，据推测是由于冠状动脉痉挛引起的。我们报告了一例 43 岁女性的病例，她因服用氟氯西林而发生过敏反应。她接受了肌肉内注射肾上腺素治疗，随后出现缺血性胸痛和心电图改变，并伴有肌钙蛋白升高。随后的冠状动脉造影显示正常的冠状动脉。在本病例报告中，我们讨论了先前使用非选择性β受体阻滞剂普萘洛尔的潜在作用，这种作用可能使此类患者在接受肾上腺素治疗后易发生缺血性心脏事件。
