scholarly journals RECURRENT TORSADES DE POINTES AND CARDIAC ARREST IN A PATIENT MISUSING LOPERAMIDE FOR EUPHORIC EFFECT

2021 ◽  
Vol 77 (18) ◽  
pp. 2059
Author(s):  
Kavin Sundaram ◽  
Vishal Goyal
Keyword(s):  
Cardiac Arrest ◽  
Torsades De Pointes

Loperamide Induced Recurrent Torsades de Pointes: A Case Report

2021 ◽  
pp. 089719002110048
Author(s):  
Gregory G. Jackson ◽  
Christine R. Lopez ◽  
Elizabeth S. Bermudez ◽  
Nina E. Hill ◽  
Dan M. Roden ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Torsades De Pointes ◽  
Altered Mental Status ◽  
Spontaneous Circulation ◽  
Prior History ◽  
Common Phenomenon ◽  
Medical Providers ◽  
Return Of Spontaneous Circulation ◽  
History Of ◽  
Overdrive Pacing

Purpose: A case of loperamide-induced recurrent torsades de pointes is reported to raise awareness of an increasingly common phenomenon that could be encountered by medical providers during the current opioid epidemic. Summary: A 40 year-old-man with a prior history of opioid abuse who presented to the emergency department after taking up to 100 tablets of loperamide 2 mg daily for 5 years to blunt opioid withdrawal symptoms and was subsequently admitted to the intensive care unit for altered mental status and hyperthermia. The patient had prolonged QTc and 2 episodes of torsades de pointes (TdP) that resulted in cardiac arrest with return of spontaneous circulation. He was managed with isoproterenol, overdrive pacing, and methylnatrexone with no other events of TdP or cardiac arrest. Conclusion: A 40-year-old male who developed torsades de pointes from loperamide overdose effectively treated with overdrive pacing, isoproterenol, and methylnatrexone.

scholarly journals Prolonged QTc: "Mind the Gap"

2014 ◽  
Vol 2 (1) ◽  
pp. 44-45
Author(s):  
Ahmad Mursel Anam ◽  
Raihan Rabbani ◽  
Farzana Shumy ◽  
M Mufizul Islam Polash ◽  
M Motiul Islam ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Long Qt Syndrome ◽  
Qt Interval ◽  
Torsades De Pointes ◽  
Junior Doctors ◽  
Long Qt ◽  
Acquired Long Qt Syndrome ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
Qt Syndrome

We report a case of drug induced torsades de pointes, following acquired long QT syndrome. The patient got admitted for shock with acute abdomen. The initial prolonged QT-interval was missed, and a torsadogenic drug was introduced post-operatively. Patient developed torsades de pointes followed by cardiac arrest. She was managed well and discharged without complications. The clinical manifestations of long QT syndromes, syncope or cardiac arrest, result from torsades de pointes. As syncope or cardiac arrest have more common differential diagnoses, even the symptomatic long QT syndrome are commonly missed or misdiagnosed. In acquired long QT syndrome with no prior suggestive feature, it is not impossible to miss the prolonged QT-interval on the ECG tracing. We share our experience so that the clinicians, especially the junior doctors, will be more alert on checking the QT-interval even in asymptomatic patients. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19970 Bangladesh Crit Care J March 2014; 2 (1): 44-45

Accelerated idioventricular rhythm resulting in torsades de pointes and cardiac arrest in a child: successfully cryoablated in left’coronary cusp

2019 ◽  
Vol 30 (3) ◽  
pp. 418-421 ◽  
Author(s):  
Yakup Ergul ◽  
Hasan C. Kafali ◽  
Fahrettin Uysal
Keyword(s):  
Cardiac Arrest ◽  
Specific Treatment ◽  
Torsades De Pointes ◽  
Left Ventricular ◽  
Electrophysiologic Study ◽  
Premature Ventricular Contractions ◽  
Cardiac Functions ◽  
Idioventricular Rhythm ◽  
Life Threatening ◽  
Coronary Cusp

AbstractKnown as a benign arrhythmia and normally requiring no specific treatment, accelerated idioventricular rhythm can rarely degenerate to a life-threatening arrhythmia. Here, we present a child with left coronary cusp-originating accelerated idioventricular rhythm, degenerating into torsades de pointes and resulting in cardiac arrest, which was ablated with a cryocatheter. An 11-year-old boy, followed due to asymptomatic accelerated idioventricular rhythm before, was referred to our department because he had experienced an aborted cardiac arrest during sleep. He had been resuscitated for 5 minutes. Twenty-four-hour Holter-ECG revealed incessant accelerated idioventricular rhythm, consisting up to 90% of the whole record and two torsades de pointes attacks, triggered by accelerated idioventricular rhythm-induced “R on T” phenomenon, and resulting in syncope and cardiac arrest. Transthoracic echocardiography revealed no structural cardiac defect but mild left ventricular systolic dysfunction with an ejection fraction of 45% and shortening fraction 23%. An electrophysiologic study was conducted, and accelerated idioventricular rhythm focus was mapped to left aortic coronary cusp. A cryocatheter with an 8-mm tip was preferred for successful ablation of the accelerated idioventricular rhythm focus, due to close neighbourhood to coronary ostium. The patient was discharged in 3 days without any premature ventricular contractions or accelerated idioventricular rhythm and with normalised cardiac functions. After 9 months on follow-up, he was still asymptomatic, without any premature ventricular contractions or accelerated idioventricular rhythm and with normal cardiac functions. Although the clinical course of accelerated idioventricular rhythm is known as benign, accelerated idioventricular rhythm can rarely degenerate to a life-threatening arrhythmia. In such cases, electrophysiologic study and catheter ablation are a good option in such cases with accelerated idioventricular rhythm for an ultimate cure.

scholarly journals 21. Prolonged QT Intervals in Patients with Out-of-Hospital Ventricular Tachycardia Cardiac Arrest

1996 ◽  
Vol 11 (S2) ◽  
pp. S40-S40
Author(s):  
William Brady ◽  
Daniel DeBehnke ◽  
Dennis Laundrie ◽  
Jeffrey A. Skiles
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Qt Interval ◽  
Discharge Rate ◽  
Fire Department ◽  
Torsades De Pointes ◽  
Inclusion Criteria ◽  
Qt Intervals ◽  
Prolonged Qt Interval ◽  
Prolonged Qt

Objective: To determine the prevalence and outcome of out-of-hospital ventricular tachycardia (VT) cardiac arrest with a prolonged QT interval and to identify the subset with torsades de pointes (TdP).Methods: Design: Retrospective review. Setting: Fire department-based paramedic system. Participants: Non-traumatic VT cardiac arrest (1/91-12/94) with a supraventricular perfusing rhythm (SVPR) and a measurable QT interval. Interventions: QT interval was measured from a SVPR and corrected QT interval (QTc) was calculated (prolonged if ≥0.45 sec). VT was classified as polymorphic or monomorphic.Results: 190 patients met inclusion criteria. 51% of patients had a prolonged QTc (PQTc). The overall hospital discharge rate was 28.4%. No difference with respect to paramedic-witnessed arrests in each QTc group was found (25.8% normal QTc [NQTc] vs. 27.8% PQTc; p = 0.752). Patients with PQTc were less likely to be discharged from the hospital (19.6% vs. 37.6%; p = 0.01). Patients with PQTc were not more likely to have PVT (37% vs. 40%; p = 0.705). 16 (8.4%) patients had TdP. 27.8% of TdP and 26.8% of non-TdP patients were discharged (p = 0.912).

scholarly journals Arrhythmogenic Antitussive: A Case of Pediatric Benzonatate Overdose With Torsades de Pointes, Cardiac Arrest, and Complete Recovery Without Neurologic Deficits

2020 ◽  
Vol 25 (7) ◽  
pp. 642-646
Author(s):  
Mary Billington ◽  
Jakub Furmaga ◽  
Thomas Schaeffer
Keyword(s):  
Cardiac Arrest ◽  
Torsades De Pointes ◽  
Complete Recovery ◽  
Full Recovery ◽  
Neurologic Deficits

Benzonatate is a commonly prescribed antitussive with rapid and deadly effects in overdose. We report a 14-year-old female who ingested 14 capsules containing 200 mg benzonatate. Her case represents the only reported benzonatate overdose with torsades de pointes, as well as the only reported pediatric benzonatate ingestion complicated by cardiac arrest with full recovery.

scholarly journals Citalopram overdose: Late presentation of torsades de pointes (TdP) with cardiac arrest

2008 ◽  
Vol 4 (2) ◽  
pp. 101-105 ◽  
Author(s):  
Asim F. Tarabar ◽  
Robert S. Hoffman ◽  
Lewis S. Nelson
Keyword(s):  
Cardiac Arrest ◽  
Torsades De Pointes ◽  
Late Presentation

scholarly journals Loperamide Induced Torsades de Pointes: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
O. Mukarram ◽  
Y. Hindi ◽  
G. Catalasan ◽  
J. Ward
Keyword(s):  
Health Care ◽  
Cardiac Arrest ◽  
Case Report ◽  
Health Care Providers ◽  
Young Male ◽  
Torsades De Pointes ◽  
Drug Addicts ◽  
Care Providers ◽  
Review Of The Literature ◽  
Over The Counter

Abuse of over the counter drugs often gets overlooked by health care providers. Loperamide is one such over the counter drug that is often abused by drug addicts. We present here a case of a young male attaining euphoria from taking massive doses of loperamide. He developed Torsades de Pointes and subsequent cardiac arrest. We found similarities in the progression of myocardial electrical conduction abnormalities among loperamide and other previously known arrhythmogenic drugs. We intend to raise concern over the ease of availability of such drugs over the counter and increase the index of suspicion for over the counter drug abuse from our experience.

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