Cardiac conduction abnormalities and atrial arrhythmias associated with salicylate toxicity.
Cardiac side effects from aspirin are uncommon; however, severe acid-base imbalance, pulmonary edema, ventricular ectopic activity and cardiopulmonary arrest have been reported in patients with toxic serum salicylate concentrations. We saw a patient with salicylate toxicity who developed a variety of sinus and atrioventricular nodal conduction disturbances and atrial arrhythmias with a relatively low toxic serum salicylate concentration. The cardiac rhythm returned to normal as the serum salicylate concentration decreased, and results of subsequent electrophysiologic testing and Holter monitoring were normal. A low serum albumin level may have resulted in altered salicylate binding in this patient, thereby increasing the availability of unbound (active) drug for toxic effects.
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001241:Aspirin / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans; D012459:Salicylates / Q000009:adverse effects*; D020156:Salicylic Acid
D012459:Salicylates; D020156:Salicylic Acid; D001241:Aspirin