Opioid Toxicity – Heroin Abuser with Sudden Shortness of Breath – Clinical Patient Case of the Week

Andrea Eberly, MD, MS, FAAEMClinical Pearls, Emergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Personal Education, Physician Assistant, Urgent Care

Opioid Toxicity - Heroin Abuser with Sudden Shortness of Breath - Clinical Patient 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 and Answer Resource, part of Med-Challenger's library of board exam review and CME question banks.

For more free clinical knowledge review questions, subscribe to the Med-Challenger Medical Education Blog

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.

See the Answer:

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