title: [Efficacy of intravenous administration of calcium on sinus dysfunction developed under diltiazem. Apropos of 4 cases].
abstract: Four cases of sinus node dysfunction with junctional escape which developed during oral treatment with diltiazem in the usual therapeutic doses (180 to 240 mg/day) are reported. In one case the cardiac toxicity of diltiazem may have been potentiated by amiodarone taken concomitantly. In two cases a biological liver alteration may have modified the metabolism of diltiazem by slowing down its degradation. In all 4 patients, a slow intravenous injection of 1 g of calcium chloride resulted in rapid and lasting restoration of a normal sinus rhythm, making temporary ventricular pacing unnecessary. The authors underline the value of calcium administration as a therapeutic test in all disorders of cardiac rhythm or conduction occurring in patients treated with calcium channel blocking agents.
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000139:chemically induced / Q000188:drug therapy*; D002122:Calcium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D004110:Diltiazem / Q000009:adverse effects* / Q000494:pharmacology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged
chemical_list: D004110:Diltiazem; D002122:Calcium Chloride
vernacular_title: Efficacité de l'administration de calcium intraveineux sur une dysfonction sinusale apparue sous diltiazem. A propos de 4 observations.