Acta clinica Croatica, Vol. 52. No. 4., 2013.
Ostalo
A Case of Recurrent Arrhythmia in an Acute Pancreatitis Patient – Pathophysiological Explanation Using Shortage of ‘Repolarization Reserve’
Uvelin Arsen
orcid.org/0000-0002-5930-0089
Hajduković Danica
Vrsajkov Vladimir
Kolak Radmila
Lazukić Aleksandra
Vicković Sanja
Gojković Zoran
Sažetak
We report a case of a patient with acute pancreatitis who developed serious heart rhythm abnormalities on three occasions, two of which were associated with administration of the first generation antihistamine chloropyramine, and the third one with hypomagnesemia and hypokalemia. Dysrhythmic events consisted of bigeminy, multifocal ventricular extrasystoles and torsades de pointes-like ventricular tachycardia. Electrocardiographic changes in acute pancreatitis
in the absence of previous heart disease can occur in more than half of the cases. Antihistamines are medications that are known to produce heart rhythm disturbances, especially the second generation drugs astemizole and terfenadine. This is the first report of chloropyramine causing dysrhythmia. It seems that acute pancreatitis patients are especially prone to heart dysrhythmia caused by different factors such as electrolyte disturbances and pronounced vagal tone. Acute pancreatitis may be added to the list of risk factors with altered ‘repolarization reserve’, predisposing to drug-induced QT interval prolongation and possible torsades de pointes occurrence.
Ključne riječi
Pancreatitis; Antihistamines; Magnesium deficiency; Hypokalemia; Arrhythmias, cardiac; Torsades de pointes; Long QT syndrome – chemically induced; Case report
Hrčak ID:
123071
URI
Datum izdavanja:
1.12.2013.
Posjeta: 2.224 *