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A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

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Published on: April 26, 2015

Morphine-induced cardiogenic shock.

Colin Feeney¹, Chizobam Ani, Naini Sharma

¹Critical Care Division, Alameda County Medical Center, Oakland, CA, USA. cfeeney@acmedctr.org

The Annals of Pharmacotherapy

|May 19, 2011

Summary

This case report details a unique instance of morphine-induced cardiogenic shock, a potentially serious side effect of opioid analgesics. The patient

Area of Science:

Cardiology
Pharmacology

Background:

Animal and human models suggest morphine may suppress myocardial contractility.
Clinical reports of this effect are notably absent.
This case highlights a unique clinical observation.

Observation:

A 44-year-old woman with acute pancreatitis developed cardiogenic shock.
She presented with a reduced left ventricular ejection fraction (LVEF) of 26% after receiving morphine via patient-controlled analgesia.
Her condition improved rapidly after morphine discontinuation and administration of norepinephrine and naloxone.

Findings:

This is the first reported case of clinically significant morphine-induced cardiogenic shock.
Naranjo probability scale suggests probable causality between morphine and cardiogenic shock.

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Transient left ventricular dysfunction reversed with morphine cessation and naloxone treatment.

Implications:

Opioids, including morphine, can induce severe left ventricular dysfunction.
Physicians should consider myocardial depression in opioid-receiving patients with unexplained hypotension or pulmonary edema.
This underscores the importance of monitoring cardiac function in patients on opioid therapy.