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    Heroin Abuser with Sudden Shortness of Breath, Case of the Week

    Opioid Toxicity - Heroin Addict with Sudden Shortness of Breath - Clinical Patient Case of the Week

    Try this free Opioid Toxicity Case Q&A courtesy of Med-Challenger.

    This opioid toxicity case comes from our Emergency Medicine Review

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    Try this case and test your knowledge of opioid toxicity.

    A 17-year-old heroin abuser presents to the emergency department after receiving naloxone in the field for treatment of respiratory depression.

    During observation, he describes the sudden onset of shortness of breath, cough, and chest discomfort, and his pulse oximetry falls to 89% on room air.

    His chest x-ray is depicted below (see Figure).

    opioid toxicity - pulmonary edema

    Question:

    What is thought to be the reason for this clinical finding?

    Answer Options:

    Opioids have a myocardial stunning effect that results in flash pulmonary edema.

    The continuous use of heroin and other opioids results in congestive heart failure that becomes apparent after fluid administration during emergency care.

    The patient is experiencing bronchospasm from use of heroin.

    Opioids in an overdose and therapeutic dosing setting may result in noncardiogenic pulmonary edema.

     

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