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[Massive delayed-action verapamil poisoning].

A Hagège1, C Masquet, P Beaufils

  • 1Service de cardiologie, hôpital Boucicaut, Paris.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|October 1, 1990
PubMed
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A young woman experienced cardiogenic shock from a verapamil overdose, showing severe heart dysfunction and, for the first time, muscle damage. Isoproterenol was effective, but prolonged treatment was necessary.

Area of Science:

  • Cardiology
  • Clinical Pharmacology
  • Toxicology

Background:

  • Verapamil is a calcium channel blocker used for cardiovascular conditions.
  • Overdose can lead to severe toxicity, including cardiovascular collapse.
  • Sustained-release formulations may alter pharmacokinetic profiles and toxicity.

Observation:

  • An 18-year-old woman presented with cardiogenic shock following ingestion of 16.8 g of sustained-release verapamil.
  • Clinical examination revealed severe left ventricular diastolic dysfunction.
  • New-onset myalgia and elevated MM isoenzyme of creatinine kinase indicated muscular involvement.

Findings:

  • The patient developed profound cardiogenic shock and severe diastolic dysfunction.
  • This case is the first to report muscular involvement (myalgia, elevated CK-MM) in verapamil toxicity.

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  • Isoproterenol demonstrated efficacy in managing the cardiovascular compromise.

    • Implications:

    • This case highlights the potential for severe cardiotoxicity and multisystem involvement with massive verapamil overdose.
    • The findings underscore the importance of recognizing and managing muscle-related complications.
    • Prolonged treatment and intensive monitoring are crucial for favorable outcomes in severe verapamil poisoning.