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Electrocardiographic Abnormalities, Malignant Ventricular Arrhythmias, and Cardiomyopathy Associated With Loperamide Abuse
Author(s) -
VAUGHN PATRICIA,
SOLIK MICHELLE M. K.,
BAGGA SHIV,
PADANILAM BENZY J.
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13052
Subject(s) - medicine , loperamide , cardiology , qt interval , torsades de pointes , cardiomyopathy , ventricular tachycardia , ejection fraction , electrocardiography , anesthesia , heart failure , diarrhea
Electrocardiographic Abnormalities Associated With Loperamide Abuse A 20‐year‐old man presented with recurrent syncope and abnormal electrocardiogram (ECG). His evaluation revealed a prolonged QT interval >600 milliseconds, witnessed torsades de pointes (TdP), and dilated cardiomyopathy. At his initial admission, an ICD was implanted and atrial pacing at 80 beats per minute suppressed ventricular arrhythmias. The patient was readmitted with device infection and recurrent TdP leading to intubation. This led to the discovery of a hitherto unrevealed loperamide abuse and his cardiac arrhythmias and LV dysfunction were determined to be related to large doses of loperamide. Following abstinence, his ejection fraction and ECG returned to normal.