Amiodarone-Induced Pulmonary Toxicity Presenting as Hypoxemic Respiratory Failure in a Patient With Ventricular Tachycardia: A Case Report

Amiodarone-induced pulmonary toxicity (APT) is a potentially life-threatening adverse effect of a commonly prescribed antiarrhythmic agent. APT can present with a wide spectrum of clinical and radiologic manifestations, often mimicking infectious or interstitial lung diseases, making timely diagnosis a clinical challenge. We report the case of a 54-year-old male with a history of ventricular tachycardia (VT) and an implantable cardioverter-defibrillator (ICD), who presented with progressive dyspnea and hypoxemic respiratory failure three months after the initiation of oral amiodarone therapy. Imaging revealed diffuse bilateral pulmonary infiltrates, and infectious and cardiac etiologies were excluded through bronchoscopy, bronchoalveolar lavage, and cardiac evaluation. High-resolution computed tomography (HRCT) demonstrated features consistent with organizing pneumonia. Following the prompt discontinuation of amiodarone and the initiation of systemic corticosteroids, the patient exhibited marked clinical and radiological improvement. This case underscores the importance of maintaining a high index of suspicion for APT in patients on long-term amiodarone therapy presenting with new respiratory symptoms.