Unusual ECG findings mimicking complete heart block in an unrecognised calcium antagonist overdose.
We present a case of severe cardiovascular instability which required intensive care management after a myocardial infarction had been diagnosed incorrectly. Unusual ECG findings were diagnostic of calcium antagonist toxicity as the cause of the cardiovascular collapse. A discussion of the potential pitfalls in the management of patients intoxicated with these agents is undertaken. Of particular interest is the prolonged period of supportive therapy required prior to the return of an unsupported circulation. The physiological variables encountered with this type of poisoning were confirmed by the use of a PiCCO device.
Connolly
P T
PT
Department of Critical Care Medicine, Whiston Hospital, Warrington Road, Prescott, Merseyside LS5 5DR, UK. ptfconn@aol.com
Harris
C
C
D000787:Angina Pectoris / Q000188:drug therapy; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects*; D002302:Cardiac Output; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D062787:Drug Overdose / Q000175:diagnosis*; D004562:Electrocardiography; D006327:Heart Block / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009203:Myocardial Infarction / Q000175:diagnosis
D002121:Calcium Channel Blockers