scholarly journals Loperamide Induced Life Threatening Ventricular Arrhythmia

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Ankit Upadhyay ◽  
Vijaykumar Bodar ◽  
Mohammad Malekzadegan ◽  
Sharanjit Singh ◽  
William Frumkin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Arrhythmias ◽  
Cardiac Toxicity ◽  
Drug Abusers ◽  
Qtc Interval ◽  
Over The Counter ◽  
Life Threatening ◽  
Irritable Bowel ◽  
Antidiarrheal Agent ◽  
Congenital Long Qt Syndrome

Loperamide is over-the-counter antidiarrheal agent acting on peripherally locatedμopioid receptors. It is gaining popularity among drug abusers as opioid substitute. We report a case of a 46-year-old male that was presented after cardiac arrest. After ruling out ischemia, cardiomyopathy, pulmonary embolism, central nervous system pathology, sepsis, and other drug toxicity, we found out that patient was using around 100 mg of Loperamide to control his chronic diarrhea presumably because of irritable bowel syndrome for last five years and consumed up to 200 mg of Loperamide daily for last two days before the cardiac arrest. We hypothesize that the patient’s QTc prolongation and subsequent cardiac arrest are due to Loperamide toxicity. Patient experienced gradual resolution of tachyarrhythmia and gradual decrease in QTc interval during hospitalization which supports the evidence of causal relationship between Loperamide overdose and potentially fatal arrhythmias. It also provided the clue that patient may have congenital long QT syndrome which was unmasked by Loperamide causing ventricular arrhythmias. This case adds one more pearl in the literature to support that Loperamide overdose related cardiac toxicity does exist and it raises concerns over Loperamide abuse in the community.

scholarly journals POTENTIAL LIFE THREATENING CARDIAC TOXICITY FROM AN EASILY ACCESSIBLE OVER THE COUNTER DRUG

2017 ◽  
Vol 69 (11) ◽  
pp. 2375 ◽  
Author(s):  
Murtaza Mirza ◽  
Shamna Attakamvelly ◽  
Amandeep Dillon ◽  
Ray Helms ◽  
Eric Shafer
Keyword(s):  
Cardiac Toxicity ◽  
Over The Counter ◽  
Life Threatening

scholarly journals Pregnancy in long QT syndrome with implantable cardioverter-defibrillator. A case report and review of the literature

2014 ◽  
Vol 20 (1) ◽  
pp. 1-4
Author(s):  
Sandra Kutkiene˙ ◽  
Lina Gumbiene ◽  
Juratę Aganauskiene ◽  
Rima Steponenienea ◽  
Germanas Marinskisa ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
Long Qt Syndrome ◽  
Ventricular Arrhythmias ◽  
Long Qt ◽  
Cardioverter Defibrillator ◽  
Pregnancy And Delivery ◽  
Life Threatening ◽  
Qt Syndrome ◽  
Congenital Long Qt Syndrome

Summary Implantable cardioverters-defibrillators have decreasedmorbidity and mortality as well as improved quality of life in patients with life-threatening cardiac arrhythmias and allowed an increasing number of young women to reach their reproductive years. New questions and tasks arise for medical professionals as to organize appropriate management of these patients, because little is known regarding the risk and outcomes of such pregnancies. The aim of this report is to describe our centre’s first experience of pregnancy and delivery management in patient with an implantable cardioverter-defibrillator as primary prevention of ventricular arrhythmias in congenital long QT syndrome.

Abstract 17194: Incremental Value of JTc Interval in Improving Risk Stratification for Life-Threatening Ventricular Arrhythmias in Patients Considered Low Risk by LVEF

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Mohsin Khan ◽  
Susan Olet ◽  
Mohammad E Mortada ◽  
Firas Zahwe ◽  
Jodi Zilinski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Risk Stratification ◽  
Ventricular Arrhythmias ◽  
Low Risk ◽  
Operating Characteristics ◽  
Icd Implantation ◽  
P Values ◽  
Net Reclassification Improvement ◽  
Life Threatening

Introduction: ICD implantation is recommended in patients with LVEF<35%, while those with LVEF between 35 to 40% are not considered at high risk for primary prevention ICD implantation. A subset of these patients develops life threatening ventricular arrhythmias (VA) and improvement in risk stratification may help identify and implement life-saving intervention. Hypothesis: Prolonged repolarization is a marker of electrical instability and JTc interval on ECG could provide prognostic information in patients with LVEF 35-40% incremental to that from LVEF. Methods: Patients ≥18 yr with no history of VA and an ECG and echocardiogram obtained at initial encounter between 11/2011 to 12/2016 with long-term follow-up were identified. The incremental predictive ability of JTc interval on improvement in risk stratification for VA was determined by receiver operating characteristics (ROC) curve, integrated discrimination improvement (IDA) and net reclassification improvement (NRI) analysis. All tests were performed at a 5% level of significance. Results: Out of 29,700 pts that met inclusion criteria, 1,102 (3.7%) had LVEF 35-40% (mean age 70.5±14.6 yrs, 49% males, CAD 67%) and 24,894 (84%) LVEF >40% (65.9±16.3 yrs , 61.8% M). Over the mean follow-up of 4.6±4.2 years, the incidence of VT/VF/cardiac arrest was 16.1% in patients with LVEF 35-40% compared to 4.1% with LVEF >40%. For every 50 ms increase in JTc interval above 300 ms, the risk for arrhythmic event in LVEF 35-40% increased two-fold (Odds Ratio=1.83 (95 % CI 1.72-1.94, P=0.013). Incorporation of JTc to LVEF improved the C statistics (95% Confidence Limit) in the model with only LVEF from 0.56 (0.54-0.57) to 0.72 (0.70-0.73) for the model combining LVEF and JTc. In addition, NRI was estimated at 0.57, which was statistically significant with p values <0.001 while IDI was estimated as 0.015 with p values <0.001 for the model incorporating JTc to LVEF. Conclusions: In patients with LVEF 35-40% considered low risk for life threatening VA by EF, incorporating JTc interval information improved risk stratification and identified those who subsequently developed VT/VF or cardiac arrest and thus identifies a subgroup that can benefit from prophylactic ICD implantation.

scholarly journals Cardiac Arrest Following the Administration of Intravenous Diphenhydramine for Sedation to an Infant With Congenital Heart Disease

2021 ◽  
Vol 26 (3) ◽  
pp. 311-314
Author(s):  
Courtney L. Andersen ◽  
Joseph D. Tobias
Keyword(s):  
Cardiac Arrest ◽  
Trisomy 21 ◽  
First Generation ◽  
Intravenous Route ◽  
Allergic Reactions ◽  
Over The Counter ◽  
Respiratory Effects ◽  
Counter Medication ◽  
Life Threatening ◽  
Pediatric Icu

Diphenhydramine (Benadryl) is a first-generation antihistamine that is used primarily to treat allergic reactions including anaphylaxis, urticaria, and allergic rhinitis. Despite its availability as an over-the-counter medication, toxicity may occur with its use especially when administered in large doses or via the intravenous route. We present a 3-month-old infant with Trisomy 21 who suffered a cardiac arrest immediately following administration of a single 1.25 mg/kg dose of intravenous diphenhydramine, prescribed for sedation in the Pediatric ICU setting. The potential cardiovascular and respiratory effects of diphenhydramine are presented, previous reports of life-threatening adverse effects reviewed, and options to limit these effects discussed.

scholarly journals Atypical Amiodarone toxicity: Iatrogenic ataxia and dysarthria in an elderly female

2021 ◽  
Vol 7 (4) ◽  
pp. 13
Author(s):  
Amanda Warren ◽  
Dana Lin ◽  
Ashlyn Katz ◽  
Pola Boazak
Keyword(s):  
Ventricular Arrhythmias ◽  
Antiarrhythmic Drugs ◽  
Healthcare Professionals ◽  
Cardiac Toxicity ◽  
Neurological Complications ◽  
Frequency Of Occurrence ◽  
Elderly Female ◽  
Corneal Deposits ◽  
Life Threatening ◽  
Supraventricular Tachyarrhythmias

Amiodarone is one of the most frequently used antiarrhythmic drugs on the market, treating both life-threatening ventricular arrhythmias as well as supraventricular tachyarrhythmias. Some of its most commonly known side effects include corneal deposits, cardiac toxicity, pneumonitis, thyroid hormone fluctuation, and dermatological reactions. Despite the frequency of occurrence of neurological complications secondary to Amiodarone they remain to be under-recognized by healthcare professionals. This casereport aims to increase awareness of the neurological complications of Amiodarone.

scholarly journals Extracorporeal cardiopulmonary resuscitation for severe chloroquine intoxication in a child – a case report

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Thomas Ferry ◽  
Vivianne Amiet ◽  
Julia Natterer ◽  
Marie-Hélène Perez ◽  
Raymond Pfister ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cardiac Toxicity ◽  
Experimental Treatment ◽  
Neurological Impairment ◽  
The Novel ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Cardio Pulmonary Resuscitation ◽  
Life Threatening ◽  
Novel Coronavirus

Abstract Background Chloroquine use has increased worldwide recently in the setting of experimental treatment for the novel coronavirus disease (Covid-19). Nevertheless, in case of chloroquine intoxication, it can be life threatening, with cardiac arrest, due to its cardiac toxicity. Case presentation This case study reports on a 14-years-old girl who presented in cardiac arrest after an uncommon suicide attempt by ingesting 3 g of chloroquine. After 66 min of cardio-pulmonary resuscitation (CPR), extracorporeal cardiopulmonary resuscitation (ECPR) was initiated, allowing cardiac function to recover. Conclusions Chloroquine intoxication is a rare but serious condition due to its cardiac toxicity. Use of ECPR in this case of transient toxicity allowed a favorable evolution with little neurological impairment.

scholarly journals Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 205
Author(s):  
Nicola Tarantino ◽  
Domenico G. Della Rocca ◽  
Nicole S. De Leon De La Cruz ◽  
Eric D. Manheimer ◽  
Michele Magnocavallo ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Ventricular Arrhythmias ◽  
Individual Factors ◽  
Substantial Part ◽  
Arrhythmogenic Substrate ◽  
Life Threatening ◽  
History Of ◽  
Anatomic Distribution ◽  
Artery Disease ◽  
Surveillance Analysis

A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete’s age, and the operator’s expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.

Ventricular Arrhythmias in Long Term LVAD Patients - Life Threatening Situation or Nothing to Worry About?

2017 ◽  
Vol 36 (4) ◽  
pp. S432 ◽  
Author(s):  
J.G. Jungschleger ◽  
M.M. Mydin ◽  
A. Woods ◽  
M. Urban ◽  
N. Robinson ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Life Threatening ◽  
Threatening Situation
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