Intramuscular Epinephrine-Induced Transient ST-Elevation Myocardial Infarction

Area of Science:

• Cardiology
• Allergy and Immunology

Background:

• Anaphylaxis is a severe allergic reaction that can be life-threatening.
• Myocardial infarction (MI) in anaphylaxis is typically attributed to the reaction itself or high-dose intravenous epinephrine.
• MI following standard intramuscular epinephrine doses is exceptionally rare.

Purpose of the Study:

• To report a rare case of myocardial infarction (MI) following therapeutic intramuscular epinephrine administration for anaphylaxis.
• To highlight the importance of vigilance for cardiac complications even with standard epinephrine doses.

Main Methods:

• Case report of a 23-year-old male with sudden onset symptoms after food ingestion.
• Diagnosis of anaphylaxis and subsequent treatment with intramuscular epinephrine.
• Monitoring of electrocardiogram (ECG) and serum troponin levels post-epinephrine administration.

Main Results:

• The patient developed chest tightness, ST elevation on ECG, and elevated troponin immediately after intramuscular epinephrine.
• These cardiac findings were transient, resolving within 10 minutes.
• The event suggests a potential link between therapeutic epinephrine and acute cardiac changes.

Conclusions:

• Epinephrine remains a critical, life-saving treatment for anaphylaxis and should be administered promptly.
• Healthcare providers must remain aware of the potential for rare complications, such as myocardial infarction, even with standard intramuscular epinephrine doses.
• Vigilance for transient cardiac events post-epinephrine is crucial in managing anaphylaxis.