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[Suicidal poisoning with verapamil]
1Szpitala Wojewódzkiego im. J. Sniadeckiego, Białymstoku.
Insights
A young woman experienced severe cardiogenic shock due to a high dose of verapamil. Despite extensive resuscitation efforts, including calcium administration, myocardial contraction failed, highlighting verapamil toxicity.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Verapamil is a calcium channel blocker used for cardiovascular conditions.
- High-dose verapamil can lead to severe cardiovascular complications.
- Cardiogenic shock is a life-threatening condition characterized by the heart's inability to pump sufficient blood.
Abstract:
An 18-year-old woman treated in an internal medicine department for heart complaints took clandestinely a high dose of verapamil of unknown origin. She was transferred with block grade III and blood pressure fall to the Department of Cardiology, Province Hospital, where she came with severe cardiogenic+ shock. Resuscitation--electric stimulation (external and then endocavitary), heart massage, artificial ventilation, and the drugs used (orciprenaline, atropine, dopamine, calcium)--was unsuccessful, since despite the bioelectrically effective stimulation myocardial contraction were not achieved, which was probably due to deficit of calcium necessary for activation of contractile elements in muscle fibres. The toxicological investigation demonstrated verapamil (together with its metabolites) in the blood (6 micrograms/ml) and in the liver (42 micrograms/g of tissue).