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Pulmonary edema post-cardioversion: a potential calcium signalling problem.

Ahmad Hersi1, Paul W Armstrong, Jonathan B Choy

  • 1Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta.

The Canadian Journal of Cardiology
|March 8, 2006
PubMed
Summary
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Pulmonary edema is a rare complication of adenosine cardioversion for supraventricular tachycardia. This case highlights a potential adverse effect of adenosine in patients with normal heart structure.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Supraventricular tachycardia (SVT) is a common arrhythmia.
  • Adenosine is a first-line pharmacologic agent for terminating SVT.
  • Pulmonary edema is a known but rare adverse effect of adenosine.

Observation:

  • A 52-year-old woman with a structurally normal heart experienced recurrent pulmonary edema.
  • These episodes occurred after intravenous adenosine (12 mg) administration for atrioventricular nodal re-entrant tachycardia.
  • A similar tachycardia episode successfully treated with verapamil did not result in pulmonary edema.

Findings:

  • The case suggests a potential link between adenosine and acute pulmonary edema in specific patient populations.
  • The absence of cardiac structural abnormalities in the patient makes the adenosine-induced pulmonary edema unusual.

Related Experiment Videos

  • Verapamil, another SVT treatment, did not precipitate this adverse event.

    • Implications:

    • Clinicians should be aware of the potential for adenosine-induced pulmonary edema, even in patients without underlying heart disease.
    • Further investigation may be warranted to understand the mechanism of adenosine-related pulmonary edema.
    • Alternative pharmacologic agents like verapamil may be considered in patients with a history of adverse reactions to adenosine.