International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 3, Issue 3 | Case Report | Open Access DOI

A Rare Case of Bupivacaine-Induced Cardiac Toxicity Presenting as Acute Coronary Syndrome in Emergency Department

Chetan Choudhary^*

Chetan Choudhary*, Shuchita Vaya, Ankita Aggarwal, Avniendra Bharadwaja, Abhay Kumar Nahar

Department of Emergency Medicine, Mahatma Gandhi Medical College &Hospital, Jaipur, Rajasthan, India

^*Correspondence to: Chetan Choudhary 

Abstract

Bupivacaine is a long-acting, local anaesthetic (LA) agent which is widely used for cutaneous infiltration, intra- articular injection, peripheral nerve blocks, epidural and spinal anaesthesia[1]. Most fatal side effects of local anaesthetics are due to the involvement of cardiovascular and central nervous system[2]. LA toxicity occurs either due to overdose of these agents or accidental intravascular injections which usually involve cardiovascular & nervous systems simultaneously. Cardiovascular side effects are mainly due to Myocardial conduction depression & negative inotropic action. Bupivacaine produces a concentration-related depression of intra-atrial, A-V nodal, intraventricular conduction and myocardial contractility owing to a fast sodium channel blocking in both nerve and cardiac tissue[3-5]. However, there has been no report concerning bupivacaine-induced myocardial injury presenting to the Emergency Department (ED) as acute coronary syndrome. We present a case mimicking acute coronary syndrome non-ST segment elevation myocardial infarction (NSTEMI), which was diagnosed as a bupivacaine- induced cardiac injury without CNS toxicity.

Keywords:

Bupivacaine; Cardiac Toxicity; Coronary Syndrome; Emergency Department

Citation:

Chetan Choudhary, Shuchita Vaya, Ankita Aggarwal, Avniendra Bharadwaja, Abhay Kumar Nahar. A Rare Case ofBupivacaine-Induced Cardiac Toxicity Presenting as Acute Coronary Syndrome in Emergency Department. Int Clinc Med CaseRepJour. 2024;3(3):1-6.