Atrial Fibrillation and Shock: Unmasking Theophylline Toxicity

Objective: The aim of this report is to describe a case of atrial fibrillation and shock precipitated by deliberate self-poisoning with theophylline. Clinical Presentation and Intervention: An 85-year-old male with severe theophylline intoxication in a suicide attempt was admitted with severe cardiac arrhythmia and shock; despite poor prognosis, he fully recovered gradually after proper diagnosis and treatment. Theophylline is a rather forgotten medication; thus, intoxication is not usually considered among the etiologies of potentially treatable cardiologic emergencies, especially when its use is intentionally concealed. Conclusion: This case highlights the importance of identifying a comprehensive medication history using all available sources of information as early as possible in an emergency department presentation.