title: Bradycardia, reversible panconduction defect and syncope following self-medication with a homeopathic medicine.
abstract: Alkaloid extracts from the plant Aconitum species have been used in various forms of herbal remedies predominantly as anti-inflammatory and analgesic agents. Many of these alkaloids are extremely potent cardiotoxins and documented cases of various arrhythmias with fatal outcomes have been reported. We report a case of self-medication with 'tincture of aconite' resulting in severe bradycardia, reversible panconduction defect evidenced by sinus inactivity, atrioventricular dissociation with idiojunctional rhythm and left bundle branch block pattern resulting in hypotension and syncope. Complete reversal of ECG findings with marked improvement in symptoms was noted within a few hours. Herbal medicines containing aconite alkaloids may result in severe cardiotoxicity, and strict regulatory measures are warranted to curb unsupervised use for therapeutic purposes.
authors.affiliation: Division of Cardiology, Department of Medicine, Calcutta Medical College, Calcutta, India.
authors.forename: S
authors.initials: S
authors.lastname: Guha
authors.forename: B
authors.initials: B
authors.lastname: Dawn
authors.forename: G
authors.initials: G
authors.lastname: Dutta
authors.forename: T
authors.initials: T
authors.lastname: Chakraborty
authors.forename: S
authors.initials: S
authors.lastname: Pain
mesh_terms: D031841:Aconitum / Q000009:adverse effects*; D000328:Adult; D001146:Arrhythmia, Sinus / Q000139:chemically induced; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D001283:Atrioventricular Node / Q000187:drug effects; D001919:Bradycardia / Q000139:chemically induced*; D002037:Bundle-Branch Block / Q000139:chemically induced; D004562:Electrocardiography / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008419:Materia Medica / Q000009:adverse effects*; D010936:Plant Extracts / Q000009:adverse effects; D012651:Self Medication / Q000009:adverse effects*; D013575:Syncope / Q000139:chemically induced*
chemical_list: D008419:Materia Medica; D010936:Plant Extracts