Journal of Anesthesia

, Volume 25, Issue 2, pp 282–285

Apical ballooning syndrome following perioperative anaphylaxis is likely related to high doses of epinephrine

  • Pascale Dewachter
  • Claudia Tanase
  • Eric Levesque
  • Pascale Nicaise-Roland
  • Sylvie Chollet-Martin
  • Claudie Mouton-Faivre
  • Dan Benhamou
Clinical Report


Apical ballooning syndrome, a reversible left ventricle dysfunction, has been reported following anaphylaxis and, during this clinical circumstance, is seemingly linked to the use of either low or high doses of epinephrine. We report a severe succinylcholine-induced IgE-mediated anaphylaxis in a 65-year-old woman, in whom the diagnosis of apical ballooning syndrome following anaphylaxis was established. As a thorough description of the clinical features and resuscitative measures could be obtained, we discuss the reasons for apical ballooning syndrome occurrence and highlight the fact that optimal care management of anaphylaxis should include a progressive titration of epinephrine.


Anaphylaxis Anesthesia Epinephrine Tako-Tsubo cardiomyopathy 


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Copyright information

© Japanese Society of Anesthesiologists 2011

Authors and Affiliations

  • Pascale Dewachter
    • 1
  • Claudia Tanase
    • 2
  • Eric Levesque
    • 3
  • Pascale Nicaise-Roland
    • 4
  • Sylvie Chollet-Martin
    • 4
    • 5
  • Claudie Mouton-Faivre
    • 6
  • Dan Benhamou
    • 7
  1. 1.Service d’Anesthésie-Réanimation and SAMU de ParisUniversité Paris-Descartes, INSERM UMRS-970 & Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de ParisParis Cedex 15France
  2. 2.Département d’Anesthésie-RéanimationHôpital Paul Brousse, Assistance Publique Hôpitaux de ParisVillejuifFrance
  3. 3.Centre Hépato-BiliaireHôpital Paul Brousse, Assistance Publique Hôpitaux de ParisVillejuifFrance
  4. 4.Unité d’Immunologie Auto-immunité & Hypersensibilités, Hôpital Bichat-Claude Bernard, Assistance Publique Hôpitaux de ParisParisFrance
  5. 5.Université Paris-Sud 11, INSERM UMRS-996Châtenay-MalabryFrance
  6. 6.Pôle d’Anesthésie-Réanimation ChirurgicaleCentre Hospitalo-Universitaire Hôpital CentralNancyFrance
  7. 7.Département d’Anesthésie-RéanimationAssistance Publique Hôpitaux de Paris, Hôpital BicêtreLe Kremlin-BicêtreFrance

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