Stress Induced Cardiomyopathy after Local Infiltration of Epinephrine for Plastic Surgery in Young Adult

젊은 성인에서 에피네프린 국소침윤 후 발생한 스트레스성 심근병증

  • So, Kyu Sub (Department of Plastic and Reconstructive Surgery, Fatima Hospital) ;
  • Hong, Yong Taek (Department of Plastic and Reconstructive Surgery, Fatima Hospital) ;
  • Kang, Hyun Jae (Department of Cardiology, Fatima Hospital) ;
  • Kim, Hoon Nam (Department of Plastic and Reconstructive Surgery, Fatima Hospital) ;
  • Lim, Young Kook (Department of Plastic and Reconstructive Surgery, Fatima Hospital) ;
  • Heo, Jun (Department of Plastic and Reconstructive Surgery, Fatima Hospital)
  • 소규섭 (대구파티마병원 성형외과) ;
  • 홍용택 (대구파티마병원 성형외과) ;
  • 강현재 (대구파티마병원 순환기내과) ;
  • 김훈남 (대구파티마병원 성형외과) ;
  • 임영국 (대구파티마병원 성형외과) ;
  • 허준 (대구파티마병원 성형외과)
  • Received : 2010.07.17
  • Accepted : 2010.09.16
  • Published : 2010.11.10

Abstract

Purpose: Epinephrine itself exhibits some cardiotoxicity. However, it rarely induces cardiomyopathy when used in standard doses during surgery for local hemostasis. This paper reports a rare case of stress-induced cardiomyopathy in a young woman after the local infiltration of epinephrine. Methods: Corrective rhinoplasty was planned in a 20-year-old woman. Lidocaine mixed with epinephrine 1:100,000 was injected around the skin of the nose and nasal septum after inducing anesthesia, which resulted in sinus tachycardia and hypotension. Postoperative ECG showed a T wave inversion in the lead V2 and echocardiography revealed transient hypokinesia in the cardiac apex. Cardiac enzyme was mildly elevated. Results: Symptoms and laboratory findings improved considerably, and the patient was discharged from hospital without complications on the sixth day after surgery. Conclusion: The prognosis of catecholamine-induced cardiomyopathy is generally favorable. However, it is important to be aware of the possible adverse effects of local epinephrine infiltration. This case highlights the need for caution when using epinephrine.

Keywords

References

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