Amiodarone‐induced pulmonary toxicity (AIPT), although rare, is a potentially life‐threatening adverse reaction 1. Amiodarone is an effective antiarrhythmic drug that was originally developed as an antianginal agent because of its vasodilator actions. Amiodarone-induced pulmonary toxicity can present acutely (hours to days after surgery or angiography) or chronically (months to years after starting amiodarone treatment). Suspicion should be heightened in patients whose daily dose of amiodarone has been more than 400 mg for more than two months or in whom a low dose has been given for more than two years.Subscribe and get access to all BMJ articles, and much more.You can download a PDF version for your personal record.If you are unable to import citations, please contact Amiodarone is associated with a wide range of adverse effects, including pulmonary toxicity.
Radiography of the patient’s chest showed diffuse interstitial and alveolar opacities, and echocardiography showed mild dysfunction of the left ventricle with an ejection fraction of 48%. Other potential causes of dyspnea were excluded (e.g. With long-term use, the prevalence of such toxicity varies between 5% and 15%.Symptoms can include progressive dyspnea, dry cough, malaise and pleuritic chest pain. The incidence of pulmonary toxicity from amiodarone is not precisely known; it is estimated to be 1 to 5 percent, depending on the dose of amiodarone . We do not capture any email address.All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.Third Department of Cardiology, Silesian Center for Heart Disease, Medical University of Silesia, Zabrze, Poland.Third Department of Cardiology, Silesian Center for Heart Disease, Medical University of Silesia, Zabrze, Poland.To sign up for email alerts or to access your current email alerts, enter your email address below:Enter multiple addresses on separate lines or separate them with commas.This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.Amiodarone-induced pulmonary toxicity: an under-recognized and severe adverse effect?Amiodarone: review of pulmonary effects and toxicityRapidly enlarging scalp nodules in a 20-month-old child
Dose and duration of treatment are not the only determinants of toxicity Copyright © 2020 BMJ Publishing Group Ltd 京ICP备15042040号-3 Pathogenesis — The mechanisms involved in amiodarone-induced interstitial pneumonitis are incompletely understood. Mortality rates due to AIPT have been reported to range from 10 to 23% 2.
Nowadays it is mostly used to treat patients with severe cardiomyopathy or coronary artery disease complicated by disturbances in the supraventricular or ventricular rhythm.The clinical features of amiodarone pulmonary toxicity may not be recognised immediately, and even when suspected the diagnosis is often difficult to establish in patients with cardiomyopathy or serious coronary artery disease who present with non-specific symptoms and findings. He had a history of ventricular tachyarrhythmia treated with amiodarone (200 mg/d for 6 years), a previous myocardial infarction and coronary artery bypass surgery.On examination, bilateral crackles could be heard on inspiration. His arterial blood gases were normal, but pulmonary function tests showed restriction with a reduced carbon monoxide–diffusing capacity (45% of predicted). Clubbing was absent. Amiodarone-induced pulmonary toxicity (AIPT), although rare, is a potentially life-threatening adverse reaction [1]. The differential diagnosis may include cardiac failure, pneumonia, and pulmonary embolism. Despite its clinical importance, there remain some unanswered questions regarding AIPT. Please note: your email address is provided to the journal, which may use this information for marketing purposes. Radiographic features can include interstitial or alveolar (ground-glass) shadows that may be localized or diffuse, and traction bronchiectases with a honeycombing pattern (Appendix 1, available at Thank you for your interest in spreading the word on CMAJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Amiodarone pulmonary toxicity, first described by Rotmensch in 1980, was initially thought to develop in 5-10% of patients and sometimes to be fatal.6 More recent studies of the drug in patients with heart failure and patients recovering from myocardial infarction have found no pulmonary toxicity.2 The explanation seems to be that pulmonary toxicity from the drug is multifactorial.7 We do not capture any email address.