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Trazodone overdose-induced Prinzmetal's angina pectoris
Bhesh Raj Karki1, Paritosh Prasai2, Asim Ruhela3
1B. P. Koirala Institute of Health SciencesDharanNepal.
Proceedings (Baylor University. Medical Center)
|February 18, 2020
Summary
Trazodone overdose can cause ST-segment elevation mimicking myocardial infarction. This case highlights the importance of considering drug toxicity in patients with chest pain and ECG changes, as recovery was uneventful.
Area of Science:
- Cardiology
- Clinical Toxicology
- Emergency Medicine
Background:
- Trazodone is an antidepressant medication.
- Overdose can lead to various cardiovascular complications.
- Electrocardiographic changes are a known, though infrequent, manifestation of trazodone toxicity.
Observation:
- A 29-year-old male presented with chest pain following intentional overdose of trazodone (1250 mg).
- Initial ECG showed significant ST-segment elevation in inferior leads (II, III, aVF) and reciprocal depression in anterior leads.
- Cardiac catheterization revealed no obstructive coronary artery disease.
Findings:
- The observed ST-segment elevation was attributed to trazodone toxicity, not acute coronary syndrome.
- Resolution of ECG abnormalities occurred with supportive care.
- The patient experienced an uneventful recovery without sequelae.
Implications:
- This case underscores the potential for trazodone overdose to induce ST-segment elevation mimicking acute myocardial infarction.
- Clinicians should consider drug-induced causes in patients presenting with chest pain and ischemic ECG changes.
- Early recognition and management of trazodone toxicity are crucial for favorable outcomes.
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