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Calcium channel blocker overdose mimicking an acute myocardial infarction.

机译:钙通道阻滞剂过量可模仿急性心肌梗塞。

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A 42-year-old man presented with shortness of breath, weakness, and diaphoresis, and developed a new left bundle branch block while under evaluation in the Emergency Department. At emergency cardiac catheterization, he was found to have only insignificant coronary disease, and a hyperdynamic ventricle. Despite these findings, he subsequently developed profound bradycardia and hypotension, which were refractory to standard therapies including pressors, calcium, and transvenous pacing. He gradually improved over several days and made a full recovery, after which he admitted to taking multiple calcium channel blockers (CCBs) in an attempt to self-medicate for symptoms he related to his lifelong paroxysmal supraventricular tachycardia. This is the first report of a CCB overdose mimicking an acute myocardial infarction, and highlights the fact that CCB overdose must be considered in the differential diagnosis of some patients who present with apparent acute myocardial infarction.
机译:一名42岁的男子出现呼吸急促,无力和发汗,并在急诊科接受评估时出现了新的左束支传导阻滞。在紧急心脏导管插入术中,发现他只有轻微的冠状动脉疾病和高动力性心室。尽管有这些发现,他随后还是出现了严重的心动过缓和低血压,这对包括加压物,钙和静脉起搏在内的标准疗法均无效。他在几天内逐渐好转并完全康复,此后他承认服用多种钙通道阻滞剂(CCB),以试图自我治疗与终身阵发性室上性心动过速有关的症状。这是第一个关于CCB过量模仿急性心肌梗死的报道,并强调了这样一个事实,即在某些表现为急性心肌梗死的患者的鉴别诊断中必须考虑CCB过量。

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