[Asthma-induced myocardial infarction in a 39-year-old woman]

A 39-year-old woman, without any previous cardiac history, is reported who developed a myocardial infarction during an attack of allergic asthma. Since childhood she has been treated with short acting beta 2-adrenoceptor agonists because of mild atopic asthma. After exposure to cat's allergen she suddenly developed a severe attack of dyspnea and cyanosis. She improved rapidly after administration of oxygen, glucocorticosteroids, aminophilline and beta 2-adrenoceptor agonist. Laboratory examinations of serum revealed elevation in enzymes activities of aminotransferases, creatinine phosphokinase and troponin I. In spite of absence of typical electrocardiographic changes we suspected myocardial infarction. The diagnosis was confirmed by echocardiography, which showed akinesis of anterior wall of the heart. On the base of relevant literature we discuss the hypothesis of cardiac necrosis in severe attack of asthma and the role of cardiac enzymes, especially troponin, in the process of diagnosis.