PDF(Pubmed)
Abstract：
Stress cardiomyopathy is a transient left ventricular dysfunction caused by physiologic or pathologic stressors. Anaphylaxis is a hypersensitivity disorder that can lead to a rapid life-threatening respiratory collapse. It happens due to exposure to allergens including medications. During anaphylaxis, there is a compensatory release of catecholamines that can lead to stress cardiomyopathy. In this case, nab-paclitaxel infusion led to anaphylaxis with respiratory failure. Echocardiogram showed features of diffuse hypokinesis with preserved basal segment contractility, and cardiac catheterization did not show any evidence of obstructive coronary artery disease. The overall clinical picture suggested stress cardiomyopathy. The patient was treated with guideline-directed medical therapy which resulted in normalization of the ejection fraction with no symptoms of congestive heart failure at any point. The patient was thereafter resumed on a reduced dose of nab-paclitaxel. This case report adds to the spectrum of infusion-related reactions associated with paclitaxel and demonstrates the course of events in the management of anaphylaxis and stress cardiomyopathy in this scenario.
摘要：
应激性心肌病是由生理或病理应激源引起的短暂性左心室功能障碍。过敏反应是一种超敏反应障碍，可导致迅速危及生命的呼吸衰竭。这是由于接触过敏原，包括药物。在过敏反应期间，儿茶酚胺的代偿性释放可导致应激性心肌病。在这种情况下,nab-紫杉醇输注导致呼吸衰竭的过敏反应。超声心动图显示弥漫性运动功能减退，基底段收缩力保留，和心导管检查没有显示任何阻塞性冠状动脉疾病的证据。总体临床表现提示应激性心肌病。患者接受了指南指导的药物治疗，导致射血分数正常化，在任何时候都没有充血性心力衰竭的症状。此后,患者恢复使用减少剂量的nab-紫杉醇。该病例报告增加了与紫杉醇相关的输注相关反应的范围，并证明了在这种情况下过敏反应和应激性心肌病的管理中的事件过程。
