Open AccessRefractory cardiogenic shock and complete heart block after unsuspected verapamil‐sr and atenolol overdose
Author(s) -
Frierson John,
Bailly Daniel,
Shultz Theodore,
Sund Sheila,
Dimas Alex
Publication year - 1991
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960141114
Subject(s) - medicine , atenolol , cardiogenic shock , verapamil , cardiology , shock (circulatory) , hypoxemia , anesthesia , embolus , dobutamine , refractory (planetary science) , hemodynamics , myocardial infarction , blood pressure , physics , astrobiology , calcium
A 57‐year‐old female presented with complete heart block and then developed refractory hypotension despite temporary pacing. Moderate left ventricular dys‐function with focal wall motion abnormalities, as well as severe hypoxemia, were demonstrated. However, neither significant coronary disease nor evidence for pulmonary embolus or other lung disease could be determined. Hemodynamic stabilization was achieved with the use of an intra‐aortic balloon pump and multiple high‐dose pressor agents. A retrospective diagnosis of toxic verapamil‐SR and atenolol ingestion was confirmed, and the patient gradually recovered. The relevant literature is reviewed and various treatment approaches are discussed.