title: Prolonged ventricular asystole: a rare adverse effect of hydrocodone use.
abstract: BACKGROUND
  Prolonged ventricular asystole is a rare vagal reaction caused by hydrocodone use. Sinus bradycardia is a characteristic presentation of the vasovagal response; examples of other presentations include arrest or atrioventricular block. Physicians need to be aware of ventricular asystole due to vagally-mediated atrioventricular block caused by hydrocodone or other opiates.
  
  
  METHODS
  We present a case of prolonged ventricular asystole in a young patient due to a vasovagal reaction caused by the hydrocodone found in the hydrocodone/acetaminophen combination.
  
  
  CONCLUSIONS
  Ventricular asystole can be a rare complication of hydrocodone found in hydrocodone/acetaminophen. Physicians need to be aware of this adverse effect, rather then resorting to expensive diagnostic interventions.
authors.affiliation: Department of Medicine, Texas A&M University Health Science Center, College Station, USA.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Sudhakaran
authors.affiliation: Research Assistant, Pulmonary Associates of Corpus Christi, Aransas Pass, USA.
authors.forename: Saherish S
authors.initials: SS
authors.lastname: Surani
authors.affiliation: Department of Medicine, Texas A&M University Health Science Center, College Station, USA.
authors.forename: Salim R
authors.initials: SR
authors.lastname: Surani
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000175:diagnosis; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D006853:Hydrocodone / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D019462:Syncope, Vasovagal / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D000701:Analgesics, Opioid; D006853:Hydrocodone