Please use this identifier to cite or link to this item: 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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