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[A suicide attempt with oral verapamil: a case report]
V M Rodríguez Blanco1, M L Rodríguez Suárez, I Möller Bustinza
1Servicio de Cardiología, Hospital Central de Asturias, Facultad de Medicina, Oviedo.
Revista Espanola De Cardiologia
|December 1, 1993
Summary
A 29-year-old experienced severe heart block after ingesting 5.28g of verapamil. Medical treatment successfully resolved the complete atrioventricular block, normalizing ECG within 36 hours.
Area of Science:
- Cardiology
- Clinical Toxicology
- Pharmacology
Background:
- Verapamil is a calcium channel blocker used to treat hypertension and arrhythmias.
- High-dose verapamil overdose can lead to severe cardiovascular complications.
- Complete atrioventricular block is a rare but serious consequence of verapamil toxicity.
Observation:
- A 29-year-old patient intentionally ingested a massive dose of verapamil (5.28 g).
- Ten hours post-ingestion, the patient developed a complete atrioventricular heart block.
- The patient presented with a normal electrocardiogram (ECG) 36 hours after medical intervention.
Findings:
- This case represents the highest reported dose of verapamil ingestion leading to toxicity.
- Prompt medical management was effective in reversing the severe bradyarrhythmia and heart block.
- Complete recovery of cardiac function was achieved without long-term sequelae.
Implications:
- This case highlights the potential for severe cardiotoxicity even with delayed presentation after verapamil overdose.
- It underscores the importance of aggressive supportive care and monitoring in managing massive calcium channel blocker ingestions.
- Further research into the management of extreme verapamil toxicity may be warranted.