Electrocardiographic changes caused by lithium intoxication in an elderly patient

Area of Science:

• Cardiology
• Clinical Toxicology

Background:

• Lithium is a common treatment for bipolar disorder.
• Lithium intoxication can lead to significant cardiac toxicity.
• Electrocardiogram (ECG) abnormalities are a known complication of lithium toxicity.

Purpose of the Study:

• To describe a case of lithium intoxication with diverse ECG abnormalities.
• To illustrate the impact of hemodialysis on ECG changes in lithium toxicity.

Main Methods:

• Case report of a 76-year-old male with lithium intoxication.
• Continuous ECG monitoring over three consecutive days.
• Assessment of ECG changes before and after hemodialysis.

Main Results:

• The patient presented with multiple ECG abnormalities: sinus bradycardia, rapid atrial fibrillation, second-degree atrioventricular block, and T wave changes.
• Following hemodialysis, serum lithium concentration decreased.
• Concurrently, the observed ECG abnormalities showed partial improvement.

Conclusions:

• Lithium intoxication can manifest with a wide spectrum of ECG changes.
• Hemodialysis is an effective intervention for reducing serum lithium levels and improving associated cardiac toxicity.
• Close ECG monitoring is crucial in managing patients with lithium intoxication.