Verapamil
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Reactions 1451 - 11 May 2013 S Verapamil Acute heart failure: case report A 36-year-old man developed acute heart failure following administration of verapamil for supraventricular tachycardia [route and time to reaction onset not stated]. The man received two doses of IV verapamil 5mg for the treatment of supraventricular tachycardia. He subsequently developed circulatory failure with a systolic BP of 65mm Hg. An ECG revealed a dilated left ventricle with an ejection fraction of 10%, and he was transferred to the ICU. Acute direct current conversion was attempted, but induction of anaesthesia resulted in a complete loss of circulation. The man underwent extraocorporeal membrane oxygenation (ECMO), but his tachycardia persisted. Electrophysiological examination showed an ectopic arrhythmia substrate in the right atrium. Following radio frequency ablation, his tachycardia stopped and his left ventricular function gradually improved. ECMO was discontinued on day 6, followed by restoration of a normal sinus rhythm. He began receiving oral heart failure therapy, and was discharged on day 24. No symptoms of heart failure were seen at last follow-up. Author comment: This case study illustrates the potentially fatal effects of verapamil. Stengaard C, et al. Fulminant acute heart failure following intravenous bolus administration of verapamil in a patient with supraventricular tachycardia. Ugeskrift for Laeger 175: 54-5, No. 12, 7 Jan 2013 [Danish; summarised from a translation] - Denmark 803086559 1 Reactions 11 May 2013 No. 1451 0114-9954/10/1451-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Verapamil
Reactions 1451 - 11 May 2013
SVerapamil
Acute heart failure: case reportA 36-year-old man developed acute heart failure following
administration of verapamil for supraventricular tachycardia[route and time to reaction onset not stated].
The man received two doses of IV verapamil 5mg for thetreatment of supraventricular tachycardia. He subsequentlydeveloped circulatory failure with a systolic BP of 65mm Hg.An ECG revealed a dilated left ventricle with an ejectionfraction of 10%, and he was transferred to the ICU. Acutedirect current conversion was attempted, but induction ofanaesthesia resulted in a complete loss of circulation.
The man underwent extraocorporeal membraneoxygenation (ECMO), but his tachycardia persisted.Electrophysiological examination showed an ectopicarrhythmia substrate in the right atrium. Following radiofrequency ablation, his tachycardia stopped and his leftventricular function gradually improved. ECMO wasdiscontinued on day 6, followed by restoration of a normalsinus rhythm. He began receiving oral heart failure therapy,and was discharged on day 24. No symptoms of heart failurewere seen at last follow-up.
Author comment: This case study illustrates thepotentially fatal effects of verapamil.Stengaard C, et al. Fulminant acute heart failure following intravenous bolusadministration of verapamil in a patient with supraventricular tachycardia.Ugeskrift for Laeger 175: 54-5, No. 12, 7 Jan 2013 [Danish; summarised from atranslation] - Denmark 803086559
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Reactions 11 May 2013 No. 14510114-9954/10/1451-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
