| Rarely seen cardiotoxicity of lithium overdose: complete heart block. | |
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MedLine Citation:
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PMID: 18068832 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Serious cardiac toxicity due to lithium toxicity is uncommon and generally only occurs in individuals with underlying heart disease. Cardiac impairment may result in dysrhythmias, including sinus bradycardia, sinoatrial block, and first-degree atrioventricular block. This paper describes a patient with complete AV block in the course of chronic lithium treatment. CASE REPORT: Fifty-seven year-old female was brought into the emergency department (ED) due to altered mental status and malaise by ambulance from hospice. She had hypertension, type-II diabetes mellitus, and depression. The caregivers told that she had been fine yesterday, had taken regular medications (lysinopril, furosemid, acetyl salicylic acid, oral antidiabetic tablets and lithium (300 mg tb/day)). Her vital signs were; blood pressure: 70/45 mmHg, pulse: 37 bpm, respiratory rate: 22 bpm, and oxygen saturation 86%. She was confused and unresponsive to verbal stimulation. Her EKG revealed total atrioventricular block. Initial biochemical results were unremarkable except for a lithium level of 2.2 mmol/l (therapeutic range 0.5-0.8 mmol/l) and an increased creatinine of 2.11 mg/dl. A transvenous pacing electrode was introduced into the right ventricle, which allowed rapid restoration of haemodynamic and neurological status. Her neurologic examination was completely normal in the follow-up period and she was discharged without sequelae. CONCLUSION: In conclusion, emergency physicians should bear in mind that complete AV block can ensue in the course of lithium toxicity and it is an entity that should be included in the differential diagnosis. |
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Authors:
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Mustafa Serinken; Ozgur Karcioglu; Ayhan Korkmaz |
Publication Detail:
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Type: Case Reports; Letter Date: 2008-02-20 |
Journal Detail:
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Title: International journal of cardiology Volume: 132 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-09 Completed Date: 2009-07-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 276-8 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Heart Block / chemically induced* Humans Lithium Compounds / adverse effects* Middle Aged |
| Chemical | |
Reg. No./Substance:
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0/Lithium Compounds |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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