A Case of Takotsubo Cardiomyopathy due to Submucosal Epinephrine Injection during Endoscopic Sinus Surgery

Abstract

Epinephrine is widely used for hemostasis during endoscopic sinus surgery performed under local and general anesthesia. However, topical epinephrine can cause many adverse effects, such as hypertension, ventricular tachycardia, pulmonary edema and cardiac arrest. Takotsubo cardiomyopathy is a newly described clinical entity characterized by transient left ventricular dysfunction and no significant coronary artery stenosis. We experienced a rare case of reversible Takotsubo cardiomyopathy in a 56-year-old male after submucosal epinephrine injection with an appropriate dose during an endoscopic sinus surgery.