Valproic Acid Overdose Review of a Case With Electrocardiographic Changes

Area of Science:

• Toxicology
• Cardiology
• Adolescent Medicine

Background:

• Valproic acid (VPA) is widely prescribed for seizures, psychiatric disorders, and headaches.
• Increasing VPA use correlates with a rise in accidental and intentional overdose cases.

Observation:

• A case report details an adolescent experiencing ischemic electrocardiographic changes following an acute VPA overdose.

Findings:

• Valproic acid overdose typically presents with respiratory depression, coma, hepatotoxicity, thrombocytopenia, and hemodynamic instability.
• Electrocardiographic abnormalities in VPA overdose commonly include tachycardia and nonspecific changes.
• Ischemic electrocardiographic changes, though rare, can occur and are usually transient.

Implications:

• This case highlights the potential for VPA overdose to induce ischemic cardiac changes in adolescents.
• Recognition of these transient ECG changes is vital for appropriate patient management.
• Supportive care, including monitoring and correction of metabolic disturbances, is the cornerstone of VPA overdose treatment.