RESUMEN
Takotsubo cardiomyopathy (TCM) secondary to an infusion reaction is extremely rare in the literature. Here, we present an unusual case of TCM in a patient with cervical squamous cell carcinoma who presented with acute hypoxic respiratory failure following the initiation of the first-cycle paclitaxel infusion therapy.
Asunto(s)
Paclitaxel , Síndrome de Dificultad Respiratoria , Cardiomiopatía de Takotsubo , Femenino , Humanos , Paclitaxel/efectos adversos , Cardiomiopatía de Takotsubo/inducido químicamente , Cardiomiopatía de Takotsubo/diagnóstico , Neoplasias del Cuello Uterino/tratamiento farmacológico , Carcinoma de Células Escamosas/tratamiento farmacológicoRESUMEN
Hypotension, poor peripheral perfusion, and tachycardia are the most common presenting signs of hemorrhagic shock. Many patients fail to show initial signs of tachycardia and paradoxically present with bradycardia. An 81-year-old man presenting with lower gastrointestinal bleed showed initial vital signs significant for tachycardia and normal blood pressure. After resuscitation with fluids and blood products, his heart rate stabilized to between 64 and 86 bpm. It later dropped to 30 bpm, which improved after administration of atropine. The patient soon experienced two episodes of hematochezia. The paradoxical bradycardia proved to be a false reassurance that the hemorrhage had resolved. Identification of paradoxical bradycardia is important in suspecting ongoing gastrointestinal hemorrhage.