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Can Bupivacaine Injection Cause Cardiac Arrest?

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Posted on Wed, 24 May 2017
Question: I received an injection of bupivacaine and had total CNS shut down. My heart stopped for 2-3 minutes. THANK GOD it started back up. MY question now is, I have significant changes to my ECHO. on 6/16 my LV mass was recorded as 106.5 grams now after this incident 4/14/17 it recorded as 170.5. Can this be due to my heart stopping and starting? do you think it can be from this injection?
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Answered by Dr. Ilir Sharka (46 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain cardiac arrest is a known adverse effect of bupivacaine. But, I don't think that this single episode of cardiac arrest is responsible for the changes in your cardiac ultrasound.

The fact that you have had a LV mass above the normal ranges (43-95)even in your first cardiac ultrasound, could indicate possible hypertrophic cardiomyopathy, which is a known risk factor for cardiac arrhythmia and cardiac arrest.

The raise in the LV mass could be related to cardiac cardiomyopathy, which is a progressive disease. It is important to carefully examine the LV outflow tract for possible obstruction.

I would like to directly review your cardiac ultrasounds, if you can upload them for a more professional opinion. Sometimes the changes in cardiac ultrasound are also related to inter-observer variability and different methods used for measurement.

If the presence of cardiac cardiomyopathy is confirmed, considering the fact that you have had an episode of cardiac arrest (whichever is the triggering factor for that), I would recommend considering with your cardiologist the possibility of ICD implantation.

I would also recommend performing an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends and rule in/out possible cardiac arrhythmia.

Some other tests are needed to investigate for other possible causes underlying these cardiac changes:

- chest X ray study and pulmonary function tests
- arterial blood gas analysis
- complete blood count for anemia
- blood electrolytes for electrolyte imbalance
- thyroid hormone levels for thyroid dysfunction
- kidney and liver function tests.

Meanwhile, it is important to carefully consult with your dentist or anesthetist on the above issues, in case you will need to perform further injections of anesthetics.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9313 Questions

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Can Bupivacaine Injection Cause Cardiac Arrest?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain cardiac arrest is a known adverse effect of bupivacaine. But, I don't think that this single episode of cardiac arrest is responsible for the changes in your cardiac ultrasound. The fact that you have had a LV mass above the normal ranges (43-95)even in your first cardiac ultrasound, could indicate possible hypertrophic cardiomyopathy, which is a known risk factor for cardiac arrhythmia and cardiac arrest. The raise in the LV mass could be related to cardiac cardiomyopathy, which is a progressive disease. It is important to carefully examine the LV outflow tract for possible obstruction. I would like to directly review your cardiac ultrasounds, if you can upload them for a more professional opinion. Sometimes the changes in cardiac ultrasound are also related to inter-observer variability and different methods used for measurement. If the presence of cardiac cardiomyopathy is confirmed, considering the fact that you have had an episode of cardiac arrest (whichever is the triggering factor for that), I would recommend considering with your cardiologist the possibility of ICD implantation. I would also recommend performing an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends and rule in/out possible cardiac arrhythmia. Some other tests are needed to investigate for other possible causes underlying these cardiac changes: - chest X ray study and pulmonary function tests - arterial blood gas analysis - complete blood count for anemia - blood electrolytes for electrolyte imbalance - thyroid hormone levels for thyroid dysfunction - kidney and liver function tests. Meanwhile, it is important to carefully consult with your dentist or anesthetist on the above issues, in case you will need to perform further injections of anesthetics. Hope you will find this answer helpful! I remain at your disposal for any further questions whenever you need! Kind regards, Dr. Iliri