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Toxin-induced cardiovascular failure

David H Jang1, Meghan B Spyres, Lindsay Fox

  • 1Division of Medical Toxicology, Department of Emergency Medicine, School of Medicine, New York University, 462 First Avenue, 27th Street, Room A340, New York, NY 10016, USA.

Emergency Medicine Clinics of North America
|November 27, 2013
PubMed

Insights

Emergency physicians face cardiovascular emergencies in drug overdose cases. Prompt treatment for toxicologic tachycardia and bradycardia, including specific antidotes and supportive care, is crucial for patient survival.

Area of Science:

  • Toxicology
  • Cardiology
  • Emergency Medicine

Background:

  • Adverse cardiovascular events are a significant cause of death in drug overdose emergencies.
  • Emergency physicians must recognize and manage various cardiovascular complications in poisoned patients.

Purpose of the Study:

  • To outline the cardiovascular events associated with drug overdose.
  • To describe the early signs of toxin-induced cardiovascular failure.
  • To provide treatment strategies for managing cardiovascular complications in toxicology.

Main Methods:

  • Review of cardiovascular events in drug overdose.
  • Identification of early signs of cardiovascular failure.
  • Summarization of treatment protocols for toxicologic cardiovascular emergencies.

Main Results:

  • Cardiovascular events include myocardial injury, shock, tachydysrhythmias, and cardiac arrest.
  • Early signs of cardiovascular failure include bradycardia, tachycardia, and specific ECG findings.
  • Treatment for tachycardia involves supportive care and benzodiazepines; for bradycardia, fluids, atropine, calcium salts, and glucagon are used.

Conclusions:

  • Effective management of cardiovascular complications in drug overdose is critical.
  • Early recognition of signs and prompt, targeted treatment improve outcomes.
  • High-dose insulin euglycemia and intravenous lipid emulsion are vital for severe poisoning and cardiac arrest.
Keywords:
Calcium channel blockerCardiac arrestCardiac injuryDigoxinDysrhythmiaOverdoseβ-blocker

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