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[Bradycardia factitia]
S Eckert1, H M Mertens, H Mannebach
1Kardiologische Klinik, Herzzentrum Nordrhein-Westfalen, Bad Oeynhausen.
Deutsche Medizinische Wochenschrift (1946)
|March 25, 1988
Summary
A young nurse experienced severe heart rhythm issues and low blood pressure from taking too much verapamil. This case highlights the importance of considering self-medication in diagnosing arrhythmias.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Verapamil, a calcium channel blocker, is used to treat hypertension and arrhythmias.
- Myocarditis is inflammation of the heart muscle, which can lead to arrhythmias.
Observation:
- A 26-year-old male nurse presented with sinus bradycardia, passive AV nodal rhythm, and hypotension.
- Symptoms were attributed to repeated intake of 240-400 mg non-retard verapamil.
- Initial suspicion of myocarditis recurrence was investigated due to the patient's history.
Findings:
- The patient's arrhythmia and hypotension were confirmed to be self-inflicted due to verapamil overdose.
- The absence of clear indicators initially complicated the diagnosis.
Implications:
- This case underscores the necessity of including self-medication in the differential diagnosis of arrhythmias.
- Healthcare providers should maintain a high index of suspicion for self-induced toxicity, even when initially denied by the patient.