Cardiac disorders in penicillin-induced anaphylaxis. Association with intravenous epinephrine therapy

This report describes cardiac dysfunction in two patients experiencing penicillin-induced anaphylaxis. Telemetric monitoring of the patients' ECGs initially disclosed sinus rhythm. Immediately after intravenous (IV) injections of epinephrine chloride, ventricular premature beats and apparent accelerated idioventricular rhythm occurred in one patient and possible ventricular tachycardia occurred in the other. These observations demonstrate the value of ECG monitoring of patients during anaphylaxis and emphasize the potential hazards of administering epinephrine by the IV route in this clinical setting.