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Updated: Sep 14, 2025

Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension

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Acute Hydroxychloroquine Overdose With Severe and Prolonged Cardiotoxicity.

William Richardson^1,2, Dan Fisher³, Stanley Hassinger¹

¹Emergency Medicine, Prisma Health Midlands, Columbia, USA.

|July 23, 2025

Summary

This summary is machine-generated.

A hydroxychloroquine overdose case highlights severe toxicity, including hypotension and arrhythmias. Prompt emergency management with fluids, ventilation, and specific antidotes led to a full recovery.

Keywords:

cardiotoxic agents covid 19 hydroxychloroquine toxicity intentional ingestion medical icu toxin induced methemoglobinemia

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Area of Science:

Toxicology
Emergency Medicine
Pharmacology

Background:

Hydroxychloroquine prescriptions remain high post-COVID-19, despite unproven efficacy.
Overdoses of hydroxychloroquine present significant emergency management challenges.

Observation:

A 49-year-old woman ingested 24 grams of hydroxychloroquine, leading to hypotension, ventricular arrhythmias (torsades de pointes), and hypokalemia.
The patient presented to the emergency department in extremis.

Findings:

Management involved fluid resuscitation, mechanical ventilation, vasopressors, electrolyte replacement, and infusions of diazepam, sodium bicarbonate, and lidocaine.
The patient was successfully treated and discharged neurologically intact.

Implications:

This case underscores the critical need for understanding and managing severe hydroxychloroquine toxicity.
Effective emergency protocols are vital for patients with large ingestions of this medication.