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Indian Journal of Emergency Medicine 11(2):p 105-113, April - June 2025. | DOI: https://doi.org/10.21088/ijem.2395.311X.11225.6
Review Article
Ventricular Bigeminy in Anaphylactic Shock: A Rare Presentation with Epinephrine.
Niveditha Balakrishnan, Manjunath Tulasi
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Emergency Medicine 11(2):p 105-113, April - June 2025. | DOI: https://doi.org/10.21088/ijem.2395.311X.11225.6
How Cite This Article:
Balakrishnan N, Tulasi M. Ventricular bigeminy in anaphylactic shock: a rare presentation with epinephrine. Ind J Emerg Med. 2025;11(2):105-13.Timeline
Received : March 18, 2025
Accepted : April 29, 2025
Published : June 05, 2025
Abstract
Background: Anaphylaxis is a medical emergency with well-characterized cardiovascular manifestations, typically presenting with hypotension and tachycardia. However, ventricular arrhythmias in this context are exceedingly rare and underrecognized. Case Presentation: We report the case of a 19-year-old male who developed ventricular bigeminy during an episode of anaphylactic shock. He presented with hypotension, urticaria, and bradycardia. ECG revealed ventricular bigeminy. Prompt intramuscular epinephrine led to immediate improvement in blood pressure and resolution of the arrhythmia. A second episode of bigeminy followed, which also responded to epinephrine. Conclusion: Clinicians should be aware that arrhythmias like ventricular bigeminy can occur in anaphylaxis and may resolve with standard anaphylaxis treatment. Early administration of epinephrine is critical not only to reverse shock but potentially to stabilize cardiac rhythm.
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Data Sharing Statement
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Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Acknowledgements
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Conflicts of Interest
The authors report no conflicts of interest in this work.
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Cite this article
Balakrishnan N, Tulasi M. Ventricular bigeminy in anaphylactic shock: a rare presentation with epinephrine. Ind J Emerg Med. 2025;11(2):105-13.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| March 18, 2025 | April 29, 2025 | June 05, 2025 |
DOI: https://doi.org/10.21088/ijem.2395.311X.11225.6
Keywords
AnaphylaxisVentricular BigeminyArrhythmiaEpinephrineEmergency MedicineRefractory AnaphylaxisSearch for Similar Articles
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Timeline
| Received | March 18, 2025 |
| Accepted | April 29, 2025 |
| Published | June 05, 2025 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
