State of the Journal 2022: Heart Rhythm Case Reports

Emery-Dreifuss muscular dystrophy (EDMD) is inherited muscle dystrophy often accompanied by cardiac abnormalities in the form of supraventricular arrhythmias, conduction defects and sinus node dysfunction. Cardiac phenotype typically arises years after skeletal muscle presentation, though, could be severe and life-threatening. The defined clinical manifestation with joint contractures, progressive muscle weakness and atrophy, as well as cardiac symptoms are observed by the third decade of life. Still, clinical course and sequence of muscle and cardiac signs may be variable and depends on the genotype. Cardiac abnormalities in patients with EDMD in pediatric age are not commonly seen. Here we describe five patients with different forms of EDMD (X-linked and autosomal-dominant) caused by the mutations in EMD and LMNA genes, presented with early onset of cardiac abnormalities and no prominent skeletal muscle phenotype. The predominant forms of cardiac pathology were atrial arrhythmias and conduction disturbances that progress over time. The presented cases discussed in the light of therapeutic strategy, including radiofrequency ablation and antiarrhythmic devices implantation, and the importance of thorough neurological and genetic screening in pediatric patients presenting with complex heart rhythm disorders.

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EP News: Heart Rhythm Case Reports

Heart Rhythm ◽

10.1016/j.hrthm.2018.06.004 ◽

2018 ◽

Vol 15 (8) ◽

pp. 1278

Author(s):

T. Jared Bunch

Keyword(s):

Case Reports ◽

Heart Rhythm

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EP News: Heart Rhythm Case Reports

Heart Rhythm ◽

10.1016/j.hrthm.2018.07.003 ◽

2018 ◽

Vol 15 (9) ◽

pp. 1434

Author(s):

T. Jared Bunch

Keyword(s):

Case Reports ◽

Heart Rhythm

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Low-dose intravenous lipid emulsion for the treatment of severe quetiapine and citalopram poisoning

Archives of Industrial Hygiene and Toxicology ◽

10.1515/aiht-2016-67-2802 ◽

2016 ◽

Vol 67 (2) ◽

pp. 164-166 ◽

Cited By ~ 4

Author(s):

Darinka Purg ◽

Andrej Markota ◽

Damjan Grenc ◽

Andreja Sinkovič

Keyword(s):

Mechanical Ventilation ◽

Lipid Emulsion ◽

Low Dose ◽

Case Reports ◽

Dose Range ◽

Gastric Lavage ◽

Heart Rhythm ◽

Psychiatric Ward ◽

Intravenous Lipid Emulsion ◽

Caucasian Girl

AbstractThe treatment of quetiapine and/or citalopram poisoning is mainly supportive and involves gastric lavage, activated charcoal, intubation, and mechanical ventilation. Recently, however, there were reports of successful treatment with intravenous lipid emulsion. Here we report a case of a 19-year-old Caucasian girl who ingested approximately 6000 mg of quetiapine, 400 mg of citalopram, and 45 mg of bromazepam in a suicide attempt. The patient developed ventricular tachycardia and epileptic seizures 12 h after admission to the hospital. As the patient’s condition deteriorated, we combined standard therapy (intubation, mechanical ventilation, and vasopressors) with low-dose intravenous lipid emulsion (ILE) (a total of 300 mL of 20 % lipid emulsion) and normalised her heart rhythm and stopped the seizures. She was discharged to the psychiatric ward after 48 h and home after a prolonged (2-month) psychiatric rehabilitation. Intravenous lipid emulsion turned out to be effective even in the lower dose range than previously reported for quetiapine poisoning in patients presenting with seizure and ventricular arrhythmia. To our knowledge, there are no case reports describing the use of ILE in treating citalopram poisoning.

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