1/7. Pilsicainide intoxication in a patient with dehydration.An 81-year-old woman developed pilsicainide intoxication associated with dehydration. The patient had been taking pilsicainide (100 mg/day) for 1 year because of paroxysmal atrial fibrillation. Her renal function was within normal limits. One week before admission, she was suffering from pneumonia, and had appetite loss, fever, and severe fatigue. physical examination revealed dehydration. The electrocardiogram (ECG) on admission showed atrioventricular dissociation, idioventricular rhythm with marked QRS widening and QTc prolongation. The plasma concentration of pilsicainide on admission was markedly elevated at 6.2 microg/ml, approximately 6 times the therapeutic range (0.25-1.0 microg/ml). Continuous saline infusion was initiated for the treatment of dehydration,which progressively improved. As a result, sinus rhythm was recovered 2 h after admission, and the QRS and JT intervals gradually normalized. This is an interesting case because the proarrhythmia of pilsicainide was induced by dehydration.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/7. Paroxysmal atrial fibrillation in a young female patient following marijuana intoxication--a case report of possible association.Marijuana is one of the most popular drugs legally admitted for general sale in many countries. To consider it safe and unlikely to develop drug dependence is abusive. The use of marijuana as a herbal medication is being widely discussed in literature. The most promising effect of delta-9-etrahydrocannabinol seems to be observed in the case of nausea, following cancer chemotherapy. Despite its positive action on the human organism, marijuana smoking has been shown to exert adverse effects on the cardiovascular system causing well-tolerated tachycardia and/or hypotension. We also observed that marijuana abuse was associated with an increased risk of paroxysmal atrial fibrillation. The report presents a case of young healthy white subject suffering from paroxysmal atrial fibrillation following marijuana intoxication. The abuse of this substance was the most possible and identifiable risk factor for observed paroxysmal atrial fibrillation.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/7. atrial fibrillation associated with alcohol ingestion in adolescence: holiday heart in pediatrics.An alcohol-naive 16-year-old male is presented with alcohol-induced atrial fibrillation. Past medical history, review of systems, and presentation were all otherwise benign. atrial fibrillation occurred early in the intoxication at an alcohol level slightly higher than the legal limit for intoxication (153 mg/dL). His complete cardiac evaluation was otherwise normal. The atrial fibrillation was not treated aggressively and resolved as the alcohol level quickly fell to zero, consistent with his "nonalcoholic" metabolism. Complete follow-up found the adolescent with no evidence of cardiac or other disease.- - - - - - - - - - ranking = 0.4keywords = intoxication (Clic here for more details about this article) |
4/7. Severe valproic acid intoxication is associated with atrial tachycardia: secondary detoxication by hemoperfusion.valproic acid is an anticonvulsant drug which is associated with serious toxicity including fatal outcome in case of severe intoxication. Secondary detoxication by hemodialysis or hemoperfusion has been employed successfully in valproic acid intoxication. Cardiac arrhythmias have only been described rarely in valproic acid intoxication in humans. We report on a 15 year-old boy with severe valproic acid intoxication (valproic acid plasma level on admission: 1 150 mg/l) who presented with coma, hypernatremia and atrial tachycardia. The patient was successfully treated with hemoperfusion and intensive supportive care without implementation of a specific antiarrhythmic therapy. We conclude that patients with severe valproic acid intoxication may benefit from secondary detoxication. In addition to generally known symptoms valproic acid intoxication may also be associated with cardiac arrhythmias.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
5/7. Lone atrial fibrillation associated with creatine monohydrate supplementation.atrial fibrillation in young patients without structural heart disease is rare. Therefore, when the arrhythmia is present in this population, reversible causes must be identified and resolved. Thyroid disorders, illicit drug or stimulant use, and acute alcohol intoxication are among these causes. We report the case of a 30-year-old Caucasian man who came to the emergency department in atrial fibrillation with rapid ventricular response. His medical history was unremarkable, except for minor fractures of the fingers and foot. Thyroid-stimulating hormone, magnesium, and potassium levels were within normal limits, urine drug screen was negative, and alcohol use was denied. However, when the patient was questioned about use of herbal products and supplements, the use of creatine monohydrate was revealed. The patient was admitted to the hospital, anticoagulated with unfractionated heparin, and given intravenous diltiazem for rate control and intravenous amiodarone for rate and rhythm control. When discharged less than 24 hours later, he was receiving metoprolol and aspirin, with follow-up plans for echocardiography and nuclear imaging to assess perfusion. Exogenous creatine is used by athletes to theoretically improve exercise performance. Vegetarians may also take creatine to replace what they are not consuming from meat, fish, and other animal products. Previous anecdotal reports have linked creatine to the development of arrhythmia. Clinicians must be diligent when interviewing patients about their drug therapy histories and include questions about their use of herbal products and dietary supplements. In addition, it is important to report adverse effects associated with frequently consumed supplements and herbal products to the food and Drug Administration and in the literature.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
6/7. lipoma of the interatrial septum in a patient with chronic atrial fibrillation: A case report.The authors report on a 70-year-old woman with chronic atrial fibrillation that was hospitalized for digitalis intoxication and incidentally was found to have an interatrial lipoma. The diagnosis was established by transesophageal echocardiography, computed tomography (CT) scanning, and magnetic resonance imaging (MRI). Owing to the asymptomatic character and the benign nature of the tumor, a decision for conservative management was made.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
7/7. digitalis-induced cardiac arrhythmias.Six cases of digitalis intoxication presenting with cardiac arrhythmias are described. Multiple cardiac arrhythmias consisting of multifocal, or unifocal, multiform ventricular ectopic beats, bidirectional tachycardia, complete heart block, accelerated junctional rhythm with exit block, nonparoxysmal junctional tachycardia, atrial fibrillation, atrial tachycardia with block, and multifocal tachycardia were observed. The presence of such multiple arrhythmias occurring simultaneously should always suggest the high possibility of digitalis intoxication.- - - - - - - - - - ranking = 0.4keywords = intoxication (Clic here for more details about this article) |