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Cardaic arrhythmias in chloral hydrate poisoning
Acta Medica Scandinavica
|January 1, 1977
Insights
Chloral hydrate overdose can cause dangerous heart arrhythmias. Prompt treatment with lignocaine or phenytoin can help restore normal heart rhythm.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Chloral hydrate is a sedative-hypnotic with a history of clinical use.
- Overdose of chloral hydrate can lead to significant toxicity.
Observation:
- Three patients admitted to hospital after chloral hydrate overdose presented with ECG abnormalities.
- These abnormalities included supraventricular and ventricular tachyarrhythmias.
Findings:
- The mechanism may involve enhanced automaticity of cardiac pacemaker cells due to chloral hydrate metabolites.
- Intravenous lignocaine successfully treated ventricular arrhythmia in one patient.
- Phenytoin was effective in another patient where lignocaine failed.
Implications:
- This case series highlights the potential for chloral hydrate overdose to induce severe cardiac arrhythmias.
- It suggests specific antiarrhythmic agents like lignocaine and phenytoin may be effective in managing these toxic-induced arrhythmias.
- Clinicians should be aware of these cardiac risks when treating patients with chloral hydrate overdose.
Abstract:
In three patients admitted to hospital after ingestion of an overdose of chloral hydrate, the ECG showed supreventricular and ventricular tachyarrhythmias. The possible mechanism for the arrhythmias may be an enhanced automaticity of supraventricular and ventricular pacemaker cells caused by metabolites of chloral hydrate. The ventricular arrhythmia responded to i.v. treatment with lignocaine in one patient, and to phenytoin in another in whom lignocaine failed to restore a normal sinus rhythm.