Author/Editor		Žmavc, Andrej; Podbregar-Marš, Andreja; Podbregar, Matej
Title		Akutni miokardni infarkt po piku ose
Translated title		Acute myocardial infarction after wasp sting
Type		članek
Source		In: Bručan A, Gričar M, Fink A, et al, editors. Urgentna medicina: izbrana poglavja 7. Zbornik 8. mednarodni simpozij o urgentni medicini; 2001 jun 13-16; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2001
Volume		str. 269-73
Language		slo
Abstract		Recognition of acute myocardial infarction (AMI) when it is atypically manifested is difficult. It is even more difficult if AMI is precipitated and masked by another disease such as anaphylactic reaction caused by a sting of an insect. A 66-year old man with a history of diabetes mellitus on insulin therapy, arterial hypertension, occlusive arteriopathy of lower extremities and epilepsy, came to a primary health care institution because of dyspnea and dysphagia with swelling of the base of the mouth and the tongue caused by wasp sting into the mouth three hours before. He was not known having an allergy before. He had normal vital signs, BP 110/70 mmHg and had no pain. After an initial therapy of acute anaphylactic reaction and suspected oedema of upper respiratory tract a prehospital emergency medical service (PEMS) was activated for the transfer to hospital. During the transport his vital signs remained normal at first, although the oxygen saturation of the arterial blood was 87%. ECG monitor revealed normal sinus rhythm. The patient received two intravenous boluses of epinephrine 0,1 mg (once before PEMS was activated and once during the transport), 2 mg of clemastine, 200 mg of methylprednisolone, 500 ml of 0.9% sodium chloride and 150 mg of teophylline. He was intubated and ventilated with oxygen. During the intubation there were no signs of glottic oedema! (Abstract truncated at 2000 characters)
Descriptors		MYOCARDIAL INFARCTION WASPS INSECT BITES AND STINGS AGED ACUTE DISEASE