Electromechanical dissociation following verapamil and propranolol ingestion: a physiologic profile.
We present a case of combined verapamil and propranolol ingestion in a young woman with a DDD pacer from whom hemodynamic, echocardiographic, and toxicologic data were obtained simultaneously. Analysis of the data from these combined sources suggests a progression of (1) recovery of myocardial contractility, (2) return of systemic vascular resistance, and (3) return of intrinsic electrical activity of the heart. That contractility returns before intrinsic electrical activity strongly for the early use of transvenous temporary pacing wires. Furthermore, our patient's complete recovery after a prolonged electromechanical dissociation arrest would again argue for very aggressive resuscitation efforts in this setting.
Waxman
A B
AB
Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn. 06520-8057, USA.
White
K P
KP
Trawick
D R
DR
D000328:Adult; D002637:Chest Pain / Q000139:chemically induced; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced; D006327:Heart Block / Q000139:chemically induced / Q000503:physiopathology; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology*; D006801:Humans; D010138:Pacemaker, Artificial; D011433:Propranolol / Q000009:adverse effects* / Q000097:blood; D014655:Vascular Resistance / Q000187:drug effects; D014700:Verapamil / Q000009:adverse effects* / Q000097:blood
D011433:Propranolol; D014700:Verapamil