Case of polymorphic ventricular tachycardia in diphenhydramine poisoning.
This is the first reported case of torsades de pointes attributable to diphenhydramine, a drug with weak I(Kr) effects. A 26-year-old, healthy man was admitted to intensive care after a diphenhydramine overdose. Results of physical examination, ECG, and electrolytes were normal at admission. Despite supportive care, he developed typical, sustained, torsades de pointes with a markedly prolonged QT interval requiring cardioversion. Drugs with weak I(Kr)-blocking effects may cause lethal proarrhythmia in susceptible individuals when delivered in high concentrations. This case illustrates the variation in repolarization reserve that exists in a free-standing population.
Joshi
Ajay K
AK
Division of Cardiovascular Diseases, Lankenau Hospital and Institute for Medical Research, Main Line Health Heart Center, Wynnewood, Pennsylvania, USA.
Sljapic
Tatjana
T
Borghei
Hassan
H
Kowey
Peter R
PR
D000328:Adult; D018926:Anti-Allergic Agents / Q000506:poisoning; D004155:Diphenhydramine / Q000506:poisoning*; D062787:Drug Overdose; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D020127:Recovery of Function; D013406:Suicide, Attempted; D016171:Torsades de Pointes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
D018926:Anti-Allergic Agents; D004155:Diphenhydramine