The Open Emergency Medicine Journal

2011, 4 : 01-05
Published online 2011 January 21. DOI: 10.2174/1876542401104010001
Publisher ID: TOEMJ-4-1

An Underestimated Cause of Dyspnea in an Emergency Setting: “Amiodarone Lung”. A Case Report and Review of the Literature

Sandra Savelli , Susannas Gamberini , Alfonsina Ricci , Elena Incasa , Massimo Tilli , Giorgio Benea and Roberto Manfredini
Clinica Medica, Department of Clinical and Experimental Medicine, University of Ferrara, via Giovecca 203, 44100 Ferrara, Italy

ABSTRACT

We are describing a case of acute onset of amiodarone-related pulmonary toxicity (amiodarone lung) presented with clinical findings of acute ingravescent dyspnea, and reversed after prompt drug discontinuation. A concise review of the characteristics of pulmonary toxicity is also provided. Lung adverse effects may occur approximately in 5-17% of treated patients, and are usually associated with older age, duration of the treatment, cumulative dosage, and probably previous co-existing lung disease may play a role. Such adverse pulmonary effects may occur either early (few days after starting treatment) or after several years, and onset of symptoms may be slowly insidious or acute, and dramatically progressive. Thus, a high level of alertness is necessary in comorbid and elderly patients receiving amiodarone, even in an emergency setting, to consider this kind of adverse reaction among all possible differential diagnoses.

Keywords:

Amiodarone, Pulmonary toxicity, Dyspnea, Emergency Department.