| Aborted sudden death, transient Brugada pattern, and wide QRS dysrrhythmias after massive cocaine ingestion. | |
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MedLine Citation:
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PMID: 11590577 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although cocaine is one of the leading causes of drug-related deaths, there is little clinical information describing the precise sequence of events leading to death in the cocaine intoxication. Usually, cocaine-related sudden deaths are unwitnessed, its electrocardiographic features are not attainable, and the majority of these patients have a rapidly fatal course and die before arriving at the hospital. We report a patient with massive cocaine ingestion who developed psychomotor agitation and generalized seizures followed by asystolic cardiac arrest. Ventilation with supplemental oxygen by endotracheal intubation immediately restored spontaneous heart beat. After resuscitation, a severe metabolic acidosis (pH 6.65) and cardiac dysrrhythmias consistent with sodium channel poisoning were detected. The electrocardiogram showed accelerated junctional rhythm at 85 beats/min with right bundle branch block and left anterior hemiblock configuration, prolongation of QRS (0.16 sec) and QTc (0.52 sec) intervals, and terminal J wave associated with coved ST-segment elevation in leads V(1) and V(2) resembling the Brugada syndrome. Sodium bicarbonate administration was quickly followed by normalization of the cardiac conduction disturbances. This article discusses the clinical and electrophysiologic implications of these findings. |
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Authors:
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J Ortega-Carnicer; J Bertos-Polo; C Gutiérrez-Tirado |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of electrocardiology Volume: 34 ISSN: 0022-0736 ISO Abbreviation: J Electrocardiol Publication Date: 2001 Oct |
Date Detail:
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Created Date: 2001-10-08 Completed Date: 2001-12-04 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0153605 Medline TA: J Electrocardiol Country: United States |
Other Details:
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Languages: eng Pagination: 345-9 Citation Subset: IM |
Affiliation:
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Intensive Care Unit and Emergency Service, Hospital Alarcos, Los Alisos 10, 13002-Ciudad Real, Spain. JORTEGACAR@NEXO.ES |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acidosis
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drug therapy Adult Cocaine / toxicity* Death, Sudden, Cardiac Dopamine Uptake Inhibitors / toxicity* Electrocardiography Heart Arrest / chemically induced*, drug therapy Heart Conduction System / drug effects* Humans Male Sodium Bicarbonate / therapeutic use Syndrome |
| Chemical | |
Reg. No./Substance:
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0/Dopamine Uptake Inhibitors; 144-55-8/Sodium Bicarbonate; 50-36-2/Cocaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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