Pseudoephedrine- induced Ventricular Tachycardia

Yıl 2013, Cilt: 10 Sayı: 12, 77 - 80, 21.03.2016

Meryem Tahmaz Baki Kumbasar Savas Ozturk Rumeyza Kazancioglu

Öz

Here, we report an unusual cause of ventricular tachycardia which had developed following pseudoephedrine intake. A 55 year old male patient was admitted to the emergency department with complaints of sustained palpitation. Monitorization records revealed ventricular tachycardia of 214 beats per minute. He had been suffering upper respiratory tract symptoms for the last two days. Palpitation had started an hour later following the ingestion of cold remedy drug, which included pseudoephedrine, and serious dyspnea gradually occurred. He had ischemic heart disease and peripheral arterial disease but he did not have a history of arrhythmia, any palpitation, diabetes mellitus or hypertension. Initially, lidocaine and later amiodorone infusion was administered but medical cardioversion was not successful. Sinus rhythm was provided after electrical cardioversion with 200 joule. Thereafter the patient was stable.

Anahtar Kelimeler

Ventricular tachycardia, pseudoephedrine, side effect

Pseudoephedrine- induced Ventricular Tachycardia

Öz

Burada psödoefedrin kullanımına bağlı nadir bir yan etki olan ventriküler taşikardi olgusu sunulmuştur. 55 yaşında erkek hasta, acil kliniğine çarpıntı şikayeti ile başvurdu. Monitörizasyonunda 214/dk hızında ventriküler taşikardi saptandı. Hasta son iki gündür üst solunum yolu infeksiyonu geçirmekteydi. Çarpıntısı, soğuk algınlığı için aldığı ve psödoefedrin içeren ilaçtan yaklaşık bir saat sonar başlamış ve giderek artan şiddetli nefes darlığı ortaya çıkmış. İskemik kalp hastalığı ve periferik arter hastalığı anamnezi olmasına rağmen aritmi, hipertansiyon veya diabetes mellitus anamnezi yoktu. Önce lidokain, sonra amiodaron infüzyonu ile uygulanan medikal kardiyoversiyon başarılı olmadı. 200 joule ile yapılan elektiriki kardiyoversiyon ile sinüs ritmi elde edildi. Daha sonra hasta stabil seyretti

Anahtar Kelimeler

Ventriküler taşikardi, psödoefedrin, yan etki

Kaynakça

• Stahmer S.A, Cowan R. Tachydysrhythmias. Emerg Med Clin North Am 2006;24: 11-40
• Giuliani E R, Gersh B J, Mc Goon MD. Mayo Clinic Practice of Cardiology. 3rd ed. St. Louis: Mosby- Wolfe;1997:780-99
• Eckardt L, Brugada P, Morgan J, Breithardt G. Ventricular tachycardia. In: Camm AJ, Lüscher TF, Serruys PW, edi- tors. The ESC Textbook of Cardiovascular Medicine. Oxford: Blackwell Publishing Ltd; 2006. p. 949-972.
• Haller CA, Benowitz NL. Cardiovascular and central nervous system events associated with dietary supple- ments containing ephedra alkaloids. N Engl J Med 2000 343:1833-8
• Alexander RW, Schlant RC, Fuster V. Hurst ‘s The Heart.9th (int) ed. New York McGraw- Hill; 1998:910-8
• Mores N, Campia U, Navarra P. No cardiovasküler ef- fects of single-dose pseudoefedrine in patients with es- sential hypertension treated with B-blokers. Eur J Clin Pharmacol 1999;55:251-4
• Kayrak M, Ülgen MS, Koç F, Soylu A. Acute myocardial in- farction triggered by xylomethasoline use in a smoking patient. Arch Turkish Soc Cardiol 2006;34:304-7
• Bright T.P, Sandage Jr B.W, Fletcher H.P. Selected cardiac and metabolic responses to pseudoephedrine with exer- cise. J Clin Pharmacol 1981;21: 488-92
• Manini F.A, Kabrhel C , Thomsen T.W. Acute myocardial infarction after over-the-counter use of pseudoephed- rine. Ann Emerg Med 2005;45: 217-8
• Bektaş F, Eken C, Oktay C. Pseudoephedrine-induced par- oxysmal supraventricular tachycardia: A case report. J Emerg Med 2008;16:21-6
• Bilge AK. Sudden death in young sportsmen and cardiovas- cular screening methods. Turkish Intervent Electrophysiol J 2005; 2:1-7