{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:20:35Z","timestamp":1786926035616,"version":"build-2736575974"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T00:00:00Z","timestamp":1691452800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Isoprenaline is widely used in the treatment of symptomatic bradycardia. Myocardial infarction precipitated by the therapeutic use of isoprenaline has not been reported in the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe the case of a 67-year-old male patient who presented to our institution with symptomatic Mobitz type II 2:1 atrioventricular block. He had a several-month history of unexplained syncope. He had several cardiovascular risk factors but did not have a diagnosis of coronary artery disease. On admission, he was symptomatic with dizziness but had no chest pain. High-sensitivity troponin I was normal. After initiation of an isoprenaline infusion, he developed cardiac-sounding chest pain and an ischaemic electrocardiogram. Emergency coronary angiography was performed that demonstrated a severe mid-vessel stenosis in his right coronary artery that was treated with percutaneous coronary intervention and the deployment of one drug-eluting stent. He remained in Mobitz type II 2:1 atrioventricular block 48 hours after the procedure, and a dual-chamber permanent pacemaker was implanted. He was discharged in a stable condition with no further chest pain or bradyarrhythmia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>To our knowledge, this is the first reported case of myocardial infarction precipitated by the therapeutic use of isoprenaline. Our hypothesis is that isoprenaline increased myocardial oxygen demand and induced a type 2 myocardial infarction in this patient with occult coronary artery disease. Isoprenaline should be used with caution in patients with confirmed or suspected coronary artery disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad358","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T12:37:58Z","timestamp":1691498278000},"source":"Crossref","is-referenced-by-count":5,"title":["Isoprenaline induced myocardial infarction in a patient with high-grade atrioventricular block: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2352-8353","authenticated-orcid":false,"given":"Ashwin","family":"Radhakrishnan","sequence":"first","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital , Mindelsohn Way, Birmingham, West Midlands, B15 2GW , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bode","family":"Ensam","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital , Mindelsohn Way, Birmingham, West Midlands, B15 2GW , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E","family":"Moody","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital , Mindelsohn Way, Birmingham, West Midlands, B15 2GW , UK"},{"name":"Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Vincent Drive, Birmingham, West Midlands, B15 2TT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F","family":"Ludman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital , Mindelsohn Way, Birmingham, West Midlands, B15 2GW , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,8]]},"reference":[{"key":"2023081010110461500_ytad358-B1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/B978-0-323-03707-5.50040-1","volume-title":"Foundations of anesthesia","author":"Barth","year":"2006"},{"key":"2023081010110461500_ytad358-B2","author":"Resuscitation Council United Kingdom"},{"key":"2023081010110461500_ytad358-B3","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"2022","author":"Zeppenfeld","year":"2022","journal-title":"Eur Heart J"},{"key":"2023081010110461500_ytad358-B4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.ejphar.2010.06.065","article-title":"Cardioprotective effect of melatonin against isoproterenol induced myocardial infarction in rats: a biochemical, electrocardiographic and histoarchitectural evaluation","volume":"644","author":"Patel","year":"2010","journal-title":"Eur J Pharmacol"},{"key":"2023081010110461500_ytad358-B5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1177\/1753944714531638","article-title":"Exploration of pharmacological interventions to prevent isoproterenol-induced myocardial infarction in experimental models","volume":"8","author":"Garg","year":"2014","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"2023081010110461500_ytad358-B6","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1139\/y84-061","article-title":"Development of isoproterenol-induced cardiac hypertrophy","volume":"62","author":"Taylor","year":"1984","journal-title":"Can J Physiol Pharmacol"},{"key":"2023081010110461500_ytad358-B7","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ejphar.2005.07.026","article-title":"Chronic \u03b2-adrenoceptor stimulation and cardiac hypertrophy with no induction of circulating renin","volume":"520","author":"Oliveira","year":"2005","journal-title":"Eur J Pharmacol"},{"key":"2023081010110461500_ytad358-B8","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1136\/hrt.33.5.759","article-title":"Electrocardiographic effects of isoprenaline in normal subjects and patients with coronary atherosclerosis","volume":"33","author":"Wexler","year":"1971","journal-title":"Br Heart J"},{"key":"2023081010110461500_ytad358-B9","first-page":"183","article-title":"Coronary spasm during cardiac electrophysiological study following isoproterenol infusion","volume":"6","author":"Kumar","year":"2014","journal-title":"Interv Med Appl Sci"},{"key":"2023081010110461500_ytad358-B10","first-page":"1","article-title":"Isoproterenol causing coronary vasospasm and ST elevations during tilt table testing","volume":"8","author":"Duong","year":"2020","journal-title":"J Investig Med High Impact Case Reports"}],"container-title":["European Heart Journal - 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