The Journal of the Association of Physicians of India
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J Assoc Physicians India · Jul 2011
Case ReportsUltra-short course of low-dose amiodarone-induced post-operative fatal pulmonary toxicity.
A 58-year-old male diabetic patient with severe left ventricular dysfunction and pulmonary arterial hypertension successfully underwent coronary artery by pass grafting (CABG) and was extubated 48 hours after surgery. Patient had atrial fibrillation on 3rd post-operative day requiring loading dose of amiodarone followed by maintenance dose to control the arrhythmia. On 4th post operative day patient became tachypnoiec and required higher concentration of oxygen to maintain SpO2 >90%. ⋯ There was good radiological and gas exchange improvement and he was extubated the following day. After one week course of steroids the infiltrates cleared and oxygenation also improved. Post CABG patients are prone for acute amiodarone toxicity and high index of suspicion is needed to diagnose this early so that fatal complication can be averted by timely intervention.