Guanfacine poisoning resulting in transient ST-segment elevation: a case report
Ichiro Hirayama1,2, Yoshito Kamijo3, Hiroko Abe3,4
1Department of Clinical Toxicology, Faculty of Medicine, Saitama Medical University, Saitama, Japan. ichirohirayama1983@gmail.com.
International Journal of Emergency Medicine
|April 26, 2024
Summary
Guanfacine poisoning in a teen led to impaired consciousness and bradycardia. Cardiovascular events like ST-segment elevation occurred, emphasizing the need for careful monitoring during guanfacine overdose.
Area of Science:
- Pharmacology
- Cardiology
- Toxicology
Background:
- Guanfacine, an alpha-2 adrenergic agonist, reduces sympathetic outflow.
- Increased use for ADHD correlates with rising guanfacine poisoning cases.
Purpose of the Study:
- To report a case of guanfacine poisoning in an adolescent.
- To highlight potential cardiovascular complications of guanfacine overdose.
Main Methods:
- A 15-year-old male with ADHD ingested 40 tablets of guanfacine.
- Clinical presentation, ECG findings, and treatment (gastric lavage, activated charcoal) were documented.
- Coronary computed tomography was performed to rule out stenosis.
Main Results:
- The patient presented with impaired consciousness and sinus bradycardia.
- ST-segment elevation developed on ECG, resolving as guanfacine levels decreased.
- No coronary artery stenosis was found.
Conclusions:
- Guanfacine poisoning can cause significant cardiovascular events.
- Close monitoring is crucial for patients with guanfacine overdose.
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