Document Detail


Aborted sudden death, transient Brugada pattern, and wide QRS dysrrhythmias after massive cocaine ingestion.
MedLine Citation:
PMID:  11590577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J Ortega-Carnicer; J Bertos-Polo; C Gutiérrez-Tirado
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  34     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-08     Completed Date:  2001-12-04     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  345-9     Citation Subset:  IM    
Affiliation:
Intensive Care Unit and Emergency Service, Hospital Alarcos, Los Alisos 10, 13002-Ciudad Real, Spain. JORTEGACAR@NEXO.ES
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MeSH Terms
Descriptor/Qualifier:
Acidosis / 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:
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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