Verapamil overdose
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Third degree atrioventricular block: case report A 33-year-old woman developed third degree atrioventricular (AV) block after ingesting an overdose of verapamil with suicidal intent. The woman was hospitalised 5 hours after ingesting verapamil [therapeutic indication not stated], with presenting symptoms of drowsiness, bradycardia and hypotension. ECG examination indicated third degree AV block with a HR of 32 beats/minute. The woman underwent gastric lavage and received activated charcoal. Laboratory tests revealed metabolic acidosis, leucocytosis, hypokalaemia and hyperglycaemia. She was transferred to the ICU and, 1 hour later, she experienced cardiac shock, respiratory arrest and rapid hypotension resulting from asystole. She received immediate aggressive treatment, followed by repeated calcium gluconate, epinephrine [adrenaline], atropine and dopamine. Over the next 2 hours, her BP normalised and her HR fluctuated between 55 and 60 beats/minute. Five hours later, her HR and arterial BP normalised and remained stable. After extubation 16 hours later, she reported intentionally ingesting 50 tablets of verapamil, each 80mg. Her recovery was notable for first degree AV block, sinus rhythm and the presence of negative T-waves. Marjanovic VS, et al. A case of severe verapamil intoxication. Serbian Journal of Experimental and Clinical Research 11: 33-36, No. 1, Apr 2010 803020389 Serbia
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Reactions 19 Jun 2010 No. 1306
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