{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:45:47Z","timestamp":1782722747229,"version":"3.54.5"},"reference-count":11,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Anaphylaxis is a serious systemic hypersensitivity reaction that, without swift medical intervention, can be life-threatening. First-line treatment in adults is with 0.01 mg\/kg (maximum 0.5 mg) of intramuscular epinephrine. However, inadvertent administration of epinephrine intravenously can lead to serious cardiovascular ramifications. This case describes a military recruit in basic training who developed multivessel coronary vasospasm and stress cardiomyo\u00adpathy in response to an inappropriately administered dose of 1 mg of intravenous (IV) epinephrine for anaphylaxis after consuming shrimp. The majority of IV epinephrine-induced vasospasm has been documented in older individuals and those with underlying coronary artery disease. This case demonstrates that cardiovascular complications related to high doses of epinephrine can affect young, otherwise healthy individuals as well. Moreover, this case highlights the importance of appropriate dose administration and sufficient training of military medical personnel in the management of medical emergencies both stateside and in deployed settings.<\/jats:p>","DOI":"10.1093\/milmed\/usag302","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:39:12Z","timestamp":1781613552000},"source":"Crossref","is-referenced-by-count":0,"title":["Coronary Vasospasm and Acute Cardiogenic Shock Following Intravenous Epinephrine Administration in Anaphylaxis: A Case Report"],"prefix":"10.1093","author":[{"given":"Apurva","family":"Chavali","sequence":"first","affiliation":[{"name":"Uniformed Services University School of Medicine, Internal Medicine Department , Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5813-1041","authenticated-orcid":false,"given":"Ariana","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases Fellowship, Brooke Army Medical Center , Fort Sam, TX 78234,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Haller","sequence":"additional","affiliation":[{"name":"Wilford Hall Cardiology Department, JBSA-Lackland , Lackland AFB, TX 78236,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"key":"2026062904084262300_usag302-B1","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.resuscitation.2021.04.010","volume-title":"Resuscitation","author":"Dodd","year":"2021"},{"key":"2026062904084262300_usag302-B2","year":"2022"},{"key":"2026062904084262300_usag302-B3","author":"Morriello","year":"2023"},{"key":"2026062904084262300_usag302-B4","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1017\/s1481803500013890","volume-title":"CJEM","author":"Shaver"},{"key":"2026062904084262300_usag302-B5","doi-asserted-by":"publisher","first-page":"I129","DOI":"10.1161\/circ.102.suppl_1.i-129","article-title":"Part 6: Advanced cardiovascular life support: section 6: pharmacology II: agents to optimize cardiac output and blood pressure","volume":"102 (suppl. 1)","author":"American Heart Association","year":"2000","journal-title":"Circulation"},{"key":"2026062904084262300_usag302-B6","author":"Rochel-Perez","year":"2025"},{"key":"2026062904084262300_usag302-B7","author":"American College of Radiology Committee on Drugs and Contrast Media."},{"key":"2026062904084262300_usag302-B8","author":"Ahmad","year":"2023"},{"key":"2026062904084262300_usag302-B9","doi-asserted-by":"publisher","DOI":"10.33940\/001c.146867","article-title":"Wrong-route errors associated with epinephrine to treat severe type I allergic reactions","volume":"7","author":"Ro","year":"2025","journal-title":"Patient Safety"},{"key":"2026062904084262300_usag302-B10","doi-asserted-by":"publisher","first-page":"107088","DOI":"10.1016\/j.nedt.2026.107088","article-title":"Enhancing bias awareness through co-designed simulation-based education: a qualitative study","volume":"163","author":"Bonnamy","year":"2026","journal-title":"Nurse Educ Today"},{"key":"2026062904084262300_usag302-B11","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.annemergmed.2009.11.008","article-title":"Confusion about epinephrine dosing leading to iatrogenic overdose: a life-threatening problem with a potential solution","volume":"55","author":"Kanwar","year":"2010","journal-title":"Ann Emerg Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag302\/68642270\/usag302.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article-pdf\/doi\/10.1093\/milmed\/usag302\/68642270\/usag302.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:08:46Z","timestamp":1782720526000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/advance-article\/doi\/10.1093\/milmed\/usag302\/8721372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,27]]},"references-count":11,"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag302","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,27]]},"article-number":"usag302"}}