{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T08:23:34Z","timestamp":1778747014023,"version":"3.51.4"},"reference-count":19,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,2,3]]},"abstract":"<jats:p>A 67-year-old man underwent surgery under general anaesthesia to obtain a biopsy from a tumour in the left maxillary sinus. Before the procedure a mucosal detumescence containing epinephrine and cocaine was applied onto the nasal mucosa. Shortly after termination of anaesthesia the patient developed tachycardia and an abrupt rise in blood pressure followed by a drop to critical levels. The patient turned pale and clammy but denied chest pain at any time. An ECG showed inferolateral ST-segment elevation, and troponin T was elevated at 0.773\u2005ng\/mL. An acute coronary angiography demonstrated normal coronary arteries; however, left ventriculography showed apical ballooning of the left ventricle, and the diagnosis of takotsubo cardiomyopathy was made. This was confirmed by a subsequent transthoracic echocardiography. Four days later the patient had complete resolution of the symptoms, and a new echocardiography showed normalisation of the left ventricular systolic function with no signs of apical ballooning.<\/jats:p>","DOI":"10.1136\/bcr-2013-202401","type":"journal-article","created":{"date-parts":[[2014,2,19]],"date-time":"2014-02-19T04:58:53Z","timestamp":1392785933000},"page":"bcr2013202401","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Iatrogenic takotsubo cardiomyopathy induced by locally applied epinephrine and cocaine"],"prefix":"10.1136","volume":"2014","author":[{"given":"Jens","family":"Sundb\u00f8ll","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0867-5825","authenticated-orcid":false,"given":"Manan","family":"Pareek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"H\u00f8gsbro","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Aarhus University Hospital, N\u00f8rrebrogade, Aarhus C, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esben Hjorth","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,2,19]]},"reference":[{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-11-200412070-00010"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl032"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.767012"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-0608"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043046"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.6","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.2.790"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.111591"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.8","doi-asserted-by":"publisher","DOI":"10.1038\/ncpcardio1066"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200108023450507"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.10","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.6.688"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.11","doi-asserted-by":"crossref","first-page":"646","DOI":"10.12968\/hmed.2011.72.11.646","article-title":"Inverted takotsubo cardiomyopathy secondary to epinephrine injection","volume":"72","author":"Magri","year":"2011","journal-title":"Br J Hosp Med (Lond)"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-010-0266-z"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.13","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-009-0028-y"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2011.09.032"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.15","first-page":"701","article-title":"[Case of bronchial asthma complicated with Takotsubo cardiomyopathy after frequent epinephrine medication]","volume":"44","author":"Saeki","year":"2006","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.16","first-page":"229","article-title":"Delayed takotsubo cardiomyopathy caused by excessive exogenous epinephrine administration after the treatment of angioedema","volume":"25","author":"Patankar","year":"2012","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.10.044"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.18","doi-asserted-by":"publisher","DOI":"10.4065\/81.6.829"},{"key":"2025082703022368000_2014.feb19_1.bcr2013202401.19","first-page":"E378","article-title":"Transient left ventricular apical ballooning after a cocaine binge","volume":"19","author":"Daka","year":"2007","journal-title":"J Invasive Cardiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202401","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:02:33Z","timestamp":1756288953000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,19]]},"references-count":19,"alternative-id":["10.1136\/bcr-2013-202401"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202401","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,19]]}}}