Lithium toxicity with rarely reported ECG manifestations

A case of severe lithium intoxication treated successfully with hemodialysis is presented. In addition to the common neurological manifestations of toxicity the patient demonstrated three rarely reported cardiotoxic manifestations: reversible first degree A-V block, intraventricular conduction delay, and prolonged Q-T interval. These findings demonstrate the need to include lithium intoxication in the differential diagnosis of drug overdose with prominent ECG changes. The pharmacology, presenting signs and symptoms, and current treatment modalities of lithium intoxication are reviewed.