Electrocardiographic Changes Associated with Penicillin Anaphylaxis

Abstract

After the intramuscular administration of penicillin for venereal disease, two otherwise healthy young patients developed acute anaphylaxis with electrocardiographic changes. The first patient developed transient left bundle branch block, followed by ischemic ST-T waves and elevation of the cardiac enzyme levels. The second patient demonstrated acute cor pulmonale in the electrocardiogram and subsequently arrhythmias occurred, which may have been related to drug therapy. Both patients survived without residual clinical or electrocardiographic sequelae. It is suggested that the heart participates in the sensitization phenomenon and that cardiac arrhythmias or conduction disturbances may be among the mechanisms of sudden death in acute anaphylaxis. After the intramuscular administration of penicillin for venereal disease, two otherwise healthy young patients developed acute anaphylaxis with electrocardiographic changes. The first patient developed transient left bundle branch block, followed by ischemic ST-T waves and elevation of the cardiac enzyme levels. The second patient demonstrated acute cor pulmonale in the electrocardiogram and subsequently arrhythmias occurred, which may have been related to drug therapy. Both patients survived without residual clinical or electrocardiographic sequelae. It is suggested that the heart participates in the sensitization phenomenon and that cardiac arrhythmias or conduction disturbances may be among the mechanisms of sudden death in acute anaphylaxis.