Related Experiment Video

Updated: Sep 30, 2026

Utilizing the Modified T-Maze to Assess Functional Memory Outcomes After Cardiac Arrest
07:02

Utilizing the Modified T-Maze to Assess Functional Memory Outcomes After Cardiac Arrest

Published on: January 5, 2018

Delayed asystolic cardiac arrest after diltiazem overdose; resuscitation with high dose intravenous calcium

G K Isbister1

  • 1Discipline of Clinical Pharmacology, University of Newcastle and Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, Waratah, NSW, Australia. gsbite@bigpond.com

Emergency Medicine Journal : EMJ
|July 9, 2002
PubMed

Insights

High-dose intravenous calcium can be life-saving in severe diltiazem overdose, especially during cardiac arrest. Early consideration is vital for managing diltiazem toxicity and improving patient outcomes.

Area of Science:

  • Toxicology
  • Cardiology
  • Emergency Medicine

Background:

  • Diltiazem, a calcium channel blocker, overdose can lead to severe cardiovascular complications.
  • Mixed overdoses involving diltiazem present complex management challenges.

Observation:

  • A 51-year-old male experienced delayed, severe toxicity after a mixed overdose including diltiazem.
  • The patient developed unrecordable blood pressure, asystole, and required resuscitation with high-dose intravenous calcium and adrenaline.
  • Delayed toxicity was noted, potentially due to the lack of whole bowel irrigation.

Findings:

  • Aggressive, high-dose intravenous calcium therapy was effective in resuscitating a patient with diltiazem-induced asystole.
  • The case highlights the potential for delayed and severe cardiovascular effects in diltiazem overdose.

Implications:

  • High-dose intravenous calcium should be considered early in managing severe diltiazem overdose, particularly in cases of cardiac arrest.
  • This approach may improve survival rates in critical diltiazem toxicity scenarios.
  • The importance of timely and comprehensive decontamination, such as whole bowel irrigation, is underscored in managing mixed overdoses.

More Related Videos

Establishment of Deep Hypothermic Circulatory Arrest in Rats08:39

Establishment of Deep Hypothermic Circulatory Arrest in Rats

Published on: December 16, 2022

Related Concept Videos

Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...