The authors describe the case of a 61-year-old woman with "broken heart
syndrome" after abrupt withdrawal of OxyContin after surgery. Her medical
history revealed long-term opioid dependence associated with the treatment of
multi-joint degenerative osteoarthritis. The patient went to the emergency department
with acute-onset shortness of breath and mild chest pain a day after discharge
from the hospital following total knee replacement. She had symptoms characteristic
of acute myocardial infarction and elevated cardiac biomarkers. Tests revealed
no major coronary atherosclerosis. However, her left ventricular function was
severely decreased, and new regional wall motion abnormalities typical of broken
heart syndrome were noted. Physicians resumed opioid therapy and treated her
with bilevel positive airway pressure, diuretics, morphine, aspirin, metoprolol,
enalaprilat, intravenous heparin, nitroglycerin, and dopamine. Ventricular systolic
function resumed completely by the fourth day. This case shows the importance
of continuing adequate opioid therapy perioperatively in opioid-dependent patients
to prevent potentially life-threatening complications. Rivera JM, Locketz AJ,
Fritz KD, Horlocker TT, Lewallen DG, Prasad A, Bresnahan JF, Kinney MO. Adapted
from Mayo Clin Proc. 2006 Jun;81(6):825-8.
Read more: PMID 16770984
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the
National Library of Medicine (NLM).
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