Electrocardiographic changes with segmental akinesia after chloral hydrate overdose.
We report a case of deliberate ingestion of 12.5 g chloral hydrate in a 25-year-old psychiatric patient. Coma and life-threatening ventricular dysrhythmias were observed soon after ingestion. Repeated electrocardiographic examination was consistent with ischemic changes appearing on day 3. They were associated with segmental abnormal left ventricular wall motion by echocardiography. A coronary angiogram was performed and was normal. Toxic metabolites of chloral hydrate, trichloroethanol and trichloroacetic acid were found in the urine until day 7. This case illustrates that with halogenated aliphatic hydrocarbons, sustained changes in cardiac contractility may occur in addition to early life-threatening ventricular dysrhythmias.
Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium.
Yves
Y
Laurent
Pierre
P
Wallemacq
Vincent
V
Haufroid
Jean
J
Renkin
Antonios
A
Liolios
Philippe
P
Hantson
D000328:Adult; D002697:Chloral Hydrate / Q000009:adverse effects*; D062787:Drug Overdose; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D014693:Ventricular Fibrillation / Q000139:chemically induced*
D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate