Complete atrioventricular block after sublingual isosorbide dinitrate.
A 71-year-old woman, admitted for chest pain, received a 5 mg dose of isosorbide dinitrate sublingually. Within 2 min she became pale and diaphoretic and soon after lost consciousness. A monitor electrocardiographic lead showed sinus bradycardia followed by ventricular asystole. Sinus rhythm was restored by a precordial thump and intravenous administration of atropine. Our patient was receiving lidocaine intravenously because of ventricular premature beats. Its interaction with isosorbide is suspected of having caused the asystole.
D000368:Aged; D004347:Drug Interactions; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced; D006327:Heart Block / Q000139:chemically induced*; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000009:adverse effects*; D008012:Lidocaine / Q000009:adverse effects; D009060:Mouth Floor
D008012:Lidocaine; D007548:Isosorbide Dinitrate