Dobutamine-Induced Myoclonus in a Patient With Acute Decompensated Heart Failure and Acute Kidney Injury: A Case Report and Literature Review

TL;DR

A patient with heart failure and kidney injury developed rare muscle spasms from dobutamine, which resolved after stopping the drug.

Contribution

This case report highlights dobutamine-induced myoclonus in a patient with acute kidney injury.

Findings

A 61-year-old female developed cortical myoclonus after 26 hours of dobutamine infusion.

Symptoms resolved 36 hours after discontinuing dobutamine.

Valproic acid and diazepam were used to manage the myoclonus.

Abstract

Dobutamine is a potent β1 and a weak β2 adrenergic agonist used in the treatment of patients with acute decompensated heart failure or cardiogenic shock. Its positive inotropic effects enhance myocardial contractibility, leading to increased cardiac output. Myoclonus in patients receiving dobutamine is a rare adverse event that is not completely understood but seems to occur more commonly in patients with renal insufficiency. We present the unique case of a 61-year-old female receiving treatment for acute decompensated heart failure with acute kidney injury (AKI) who developed cortical myoclonus after 26 hours of a dobutamine infusion. Resolution occurred 36 hours after discontinuation of the dobutamine infusion. Valproic acid and diazepam were given to relieve the myoclonus. Clinicians should be aware that dobutamine-associated myoclonus is possible in patients with AKI.