scholarly journals Metoprolol-induced hyperkalemia – A case report

2020 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Kala Bahadur Rawal ◽  
Dhruba Rana Chhetri ◽  
Ashish Giri ◽  
H. N. Girish ◽  
Min Bahadur Luhar ◽  
...  
Keyword(s):  
Case Report ◽  
Troponin I ◽  
Beta Blockers ◽  
Positive Family History ◽  
Elevated Serum ◽  
Antiplatelet Agents ◽  
Hypolipidemic Agents ◽  
Patients With Diabetes ◽  
Life Threatening ◽  
2D Echocardiogram

Hyperkalemia is a condition that increased serum potassium levels, which can lead to life-threatening cardiac conditions. A 59-year-old female patient admitted to an emergency medicine ward with complaints of gradually progressive retrosternal chest pain. She was a known case of diabetes mellitus (DM), hypertension, and ischemic heart disease with a positive family history of DM and hypertension. She has treated with tablet metoprolol 12.5 mg twice daily from 20 days. On examination, the patient was restless due to unstable angina BP in the range of 110/70–180/90 mm of Hg, PR range 84–86 bpm, and SPO2 – 98%. Laboratory investigation revealed that the HbA1c was 7.19, and mean blood glucose of the past 90 days was in average control. Ultrasonography shows the Grade I renal parenchymal disease. The serum blood sugar level was elevated. Serum troponin I was 0.91 ng/ml. Ultrasonography abdomen was normal. Electro cardiogram: Sinus tachycardia suspected left inferior hemiblock, poor R-wave progression, inverted T- wave, and slide ST segments elevation and 2D-echocardiogram: IHD and RWMA at rest (basal inferior moderate left ventricle dysfunction). On hospital admission, the patient was treated with antiplatelet agents, anticoagulant, insulin, anti-ischemic agents, hypolipidemic agents, and potassium binder resins and diuretics. Patients with diabetes and kidney dysfunction have a higher risk of hyperkalemia in concomitants therapy with beta-blockers, so the health care workers should be aware of life-threatening events due to hyperkalemia secondary to beta-blockers. This case-report adds the evidence on the electrolyte related adverse drug reactions due to the beta-blockers.

Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis

2020 ◽  
Vol 13 (7) ◽  
pp. e235536
Author(s):  
Vaishnavi Divya Nagarajan ◽  
Alba Morales ◽  
Lawtanya Pleasant ◽  
Asha Shenoi
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Beta Blockers ◽  
Thyroid Storm ◽  
First Line ◽  
Bridging Therapy ◽  
Definitive Therapy ◽  
Paediatric Case ◽  
Threatening Condition ◽  
Life Threatening

Paediatric hyperthyroidism cases are mostly caused by Grave’s disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%–2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. We report a challenging case of a 15-year-old girl who presented with thyroid storm in the setting of septic shock and methimazole-induced agranulocytosis. Since the first-line agents were contraindicated, plasmapheresis was used to control the thyroid storm and as a bridging therapy to the definitive therapy of early thyroidectomy. This is the first paediatric case report that outlines the use of plasmapheresis in the management of complicated thyrotoxicosis in a setting of septic shock.

scholarly journals Quality of medication therapy in patients after stroke depending on presence/absence of diabetes: data from the outpatient stage of REGION-M registry

2021 ◽  
Vol 20 (5) ◽  
pp. 2856
Author(s):  
S. Yu. Martsevich ◽  
S. N. Tolpygina ◽  
A. V. Zagrebelny ◽  
M. I. Chernysheva ◽  
V. P. Voronina ◽  
...  
Keyword(s):  
Ace Inhibitors ◽  
Beta Blockers ◽  
Cardiovascular Prevention ◽  
Antiplatelet Agents ◽  
Angiotensin Ii Receptor ◽  
Medication Therapy ◽  
Drug Classes ◽  
Before And After ◽  
Patients With Diabetes

Aim. To assess the quality of medication treatment in the polyclinic within 2 years after discharge, depending on presence/absence of diarecommended for patients with stroke before its development and betes.Material and methods. The study included 684 patients assigned to the City Polyclinic № 64 (Moscow), discharged from F.I. Inozemtsev City Clinical Hospital (Moscow) for a period from January 1, 2012 to April 30, 2017 with a diagnosis of stroke/transient ischemic attack, of which 122 were diagnosed with diabetes.Results. Before stroke, therapy was recommended for 67,3% of patients with diabetes and 54,7% without diabetes (p<0,01): statins — 15,5 and 14,4%, antiplatelet agents — 32,7 and 25,5%, angiotensinconverting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs) — 41,4 and 37,9%, beta-blockers (BBs) — 9,1% and 7,8%, respectively. For the first 6 months after stroke, the rate of statin therapy increased to 39,6 and 39,2%, antiplatelet drugs — to 62,6 and 51,9%, ACE inhibitors/ARBs — to 68,2 and 66%, BBs — to 51,6 and 37,2%, respectively. Then, after 6 months it decreased again to 28,8 and 27,1% for statins, to 30,7 and 35,2% for antiplatelet agents, to 43,3 and 42,6% for ACE inhibitors/ARBs and remained the same for BBs, respectively. There were no significant differences in the prevalence of prescribing most drugs to patients with and without diabetes, both before and after stroke, with the exception of hypoglycemic medications.Conclusion. The therapy of patients with previous stroke, both with and without diabetes, recommended in the polyclinic, is characterized by an insufficient prescription rate of main drug classes necessary for secondary cardiovascular prevention at all follow-up stages.

Possible Metoprolol-Induced Hyperkalemia

2006 ◽  
Vol 19 (5) ◽  
pp. 320-325 ◽  
Author(s):  
John Hawboldt ◽  
Debra McGrath
Keyword(s):  
Case Report ◽  
Health Care Professionals ◽  
Adrenergic Receptor ◽  
Renal Excretion ◽  
Beta Blockers ◽  
Receptor Blockade ◽  
Potassium Intake ◽  
Life Threatening ◽  
Life Threatening Event ◽  
Insulin Insufficiency

Hyperkalemia can be a life-threatening event due to the risk of potentially fatal arrhythmias. Hyperkalemia has been reported in 1.3% (serum potassium greater than 6.0 mEq/mL) to 10% (greater than 5.3 mEq/mL) of patients. Hyperkalemia secondary to beta-adrenergic receptor blockade can occur in 1% to 5% of patients and is more likely to occur in non-cardio-selective beta-blockers versus cardio-selective beta-blockers. This case report describes hyperkalemia in a 72-year-old female with diabetes and underlying chronic renal failure receiving metoprolol. Chronically, potassium balance is maintained by the kidney. In acute situations, such as a larger than normal potassium load, both the kidney and the body's cells react to maintain normal potassium levels. Generally, hyperkalemia occurs secondary to 3 mechanisms: excessive potassium intake, disturbed cellular uptake of potassium, or impaired renal excretion of potassium. Beta-blockers, when used in patients with comorbidities such as renal dysfunction or insulin insufficiency, can potentially cause hyperkalemia. As demonstrated in this case report, hyperkalemia can occur in patients treated with cardio-selective beta-blockers with concurrent risk factors. Health care professionals need to be aware of this potentially life-threatening event to effectively prevent occurrences of beta-blocker-induced hyperkalemia.

scholarly journals Stress Induced Cardiomyopathy: A Case Report and Review of the Literature

2021 ◽  
Vol 6 (2) ◽  
pp. 280-282
Author(s):  
Shallu Chaudhary ◽  
Major Amit Atwal
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Troponin I ◽  
Beta Blockers ◽  
Exploratory Laparotomy ◽  
Left Ventricular ◽  
Stress Cardiomyopathy ◽  
Review Of The Literature ◽  
Ventricular Failure ◽  
Keywords Stress

In our study, we presented a 48 year old female patient who developed stress cardiomyopathy after undergoing two major surgeries:- left nephrectomy followed by exploratory laparotomy with limited resection of colon with colostomy. Our patient had chest pain and dyspnea. ECG and ECHO findings were consistent with findings of stress cardiomyopathy. The Troponin I and BNP levels were also raised. Our patient developed left ventricular failure which was treated with injection lasix and injection morphine. Further management included beta-blockers, ACE inhibitors, diuretics. Our patient responded to the treatment and improved progressively. Keywords: Stress induced cardiomyopathy, reversible cardiomyopathy, Takotsubo cardiomyopathy.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report

2021 ◽  
Vol 42 (4) ◽  
pp. 102977
Author(s):  
Alexander N. Goel ◽  
Andrey Filimonov ◽  
Julie Teruya-Feldstein ◽  
Christian Salib ◽  
Joseph J. Rousso ◽  
...  
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Burkitt Lymphoma ◽  
Life Threatening

scholarly journals Thermal burns in electroconvulsive therapy

2021 ◽  
pp. 201010582110310
Author(s):  
Ernest Weisheng Ho ◽  
Eng Leonard ◽  
Lee Tih-Shih ◽  
Gregory James Meredith
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Ignition Source ◽  
Thermal Burns ◽  
High Impedance ◽  
Temporal Placement ◽  
Close Proximity ◽  
Life Threatening

Electroconvulsive therapy (ECT) is effective for mood disorders and schizophrenia. Thermal burns, while rare, are potentially sight and life threatening. The three elements necessary for a fire are often in close proximity during a session: an oxidiser (oxygen), an ignition source (faulty electrodes, poor contact with skin producing a spark) and fuel (hair, residual alcohol cleanser). This case report describes one such incident when a patient sustained a burn during ECT, with poor contact of electrode pad with skin, high impedance and an oxygen-rich environment possibly contributing. Given that ECT is conducted relatively frequently (once every 2–3 days) in a usual regimen, we make recommendations for safe application of electrode pads for temporal placement ECT.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

Sign in / Sign up

Export Citation Format

Share Document