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https://hdl.handle.net/11499/6870
Title: | Rarely seen cardiotoxicity of lithium overdose: Complete heart block | Authors: | Serinken, Mustafa Karcioglu, O. Korkmaz, Ayhan |
Keywords: | Cardiotoxicity Complete heart block Lithium Overdose Third-degree atrioventricular block acetylsalicylic acid creatinine furosemide lisinopril lithium oral antidiabetic agent adult ambulance article atrioventricular block blood pressure breathing rate cardiotoxicity caregiver case report complete heart block confusion creatinine blood level depression drug blood level electrocardiogram electrode emergency ward female follow up heart pacing heart right ventricle hemodynamics hospice hospital discharge human hypertension malaise mental health neurologic examination non insulin dependent diabetes mellitus oxygen saturation physician priority journal pulse rate verbalization vital sign Female Heart Block Humans Lithium Compounds Middle Aged |
Abstract: | Introduction: Serious cardiac toxicity due to lithium toxicity is uncommon and generally only occurs in individuals with underlying heart disease. Cardiac impairment may result in dysrhythmias, including sinus bradycardia, sinoatrial block, and first-degree atrioventricular block. This paper describes a patient with complete AV block in the course of chronic lithium treatment. Case report: Fifty-seven year-old female was brought into the emergency department (ED) due to altered mental status and malaise by ambulance from hospice. She had hypertension, type-II diabetes mellitus, and depression. The caregivers told that she had been fine yesterday, had taken regular medications (lysinopril, furosemid, acetyl salicylic acid, oral antidiabetic tablets and lithium (300 mg tb/day)). Her vital signs were; blood pressure: 70/45 mmHg, pulse: 37 bpm, respiratory rate: 22 bpm, and oxygen saturation 86%. She was confused and unresponsive to verbal stimulation. Her EKG revealed total atrioventricular block. Initial biochemical results were unremarkable except for a lithium level of 2.2 mmol/l (therapeutic range 0.5-0.8 mmol/l) and an increased creatinine of 2.11 mg/dl. A transvenous pacing electrode was introduced into the right ventricle, which allowed rapid restoration of haemodynamic and neurological status. Her neurologic examination was completely normal in the follow-up period and she was discharged without sequelae. Conclusion: In conclusion, emergency physicians should bear in mind that complete AV block can ensue in the course of lithium toxicity and it is an entity that should be included in the differential diagnosis. © 2007 Elsevier Ireland Ltd. All rights reserved. | URI: | https://hdl.handle.net/11499/6870 https://doi.org/10.1016/j.ijcard.2007.08.058 |
ISSN: | 0167-5273 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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