Cardiac Arrest Post Voluntary Intoxication with Propafenone

  • Eugénia Martins de Matos Hospital Prof. Doutor Fernando Fonseca, EPE, Amadora
  • Teresa Dionísio Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra
  • Alexandra Dinis Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra
  • Igor Milet Centro Hospitalar Baixo Vouga, EPE
  • António Pires Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra
  • Leonor Carvalho Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra

Abstract

We report the case of a 17-year-old girl, observed in the emergency room 1.5 hours after voluntary ingestion of 6 grams of propafenone and 1.5 grams of ibuprofen. On arrival, she was conscious and without arrhythmias noted in the electrocardiogram. Gastric lavage was performed and activated charcoal administered. Fifteen minutes later, a convulsive episode was followed by sudden asystole, from which she recovered after 4 minutes of advanced life support. Subsequently, she had 2 episodes of asystole. She was then placed on inotropic support, but due to persistent haemodynamically significant bradycardia she required a transvenous temporary pacemaker. She was then admitted to Paediatric Intensive Care Unit, where for 72 hours post admission she remained haemodynamically unstable pacemaker-dependent. She was discharged on D8, fully recovered and without neurological deficits.

The favourable outcome was due swift institution of cardiorespiratory resuscitation measures as well as inotrope support and transvenous temporary cardiac pacing.

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Author Biographies

Eugénia Martins de Matos, Hospital Prof. Doutor Fernando Fonseca, EPE, Amadora

Department of Paediatrics

Teresa Dionísio, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra

Paediatric Intensive Care Unit, Hospital Pediátrico

Alexandra Dinis, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra

Paediatric Intensive Care Unit, Hospital Pediátrico

Igor Milet, Centro Hospitalar Baixo Vouga, EPE

Intensive Care Unit

António Pires, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra

Paediatric Cardiology Unit, Hospital Pediátrico 

Leonor Carvalho, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra

Paediatric Intensive Care Unit

Published
2019-07-15
Section
Case reports