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Successful resuscitation using external cardiac pacing in beta adrenergic antagonist-induced bradyasystolic arrest. 1988

C J Kenyon, and G E Aldinger, and P Joshipura, and G J Zaid
Department of Emergency Medicine, Saint Francis Hospital, Evanston, Illinois.

We present a case of attempted suicide by propranolol overdose presenting as convulsions followed by bradyasystolic cardiopulmonary arrest successfully managed by external transcutaneous pacing. Inotropic support and the resulting clinical improvement permitted discontinuation of cardiac pacing after 75 minutes. Pharmacologic management included glucagon late in the patient's management when the persistent hypotension was established to be due to beta adrenergic blockade. A serum propranolol level of 2,331 ng/mL verified the overdose. This is the first report of successful transcutaneous pacing for beta adrenergic antagonist poisoning.

UI MeSH Term Description Entries
D011433 Propranolol A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs. Dexpropranolol,AY-20694,Anaprilin,Anapriline,Avlocardyl,Betadren,Dociton,Inderal,Obsidan,Obzidan,Propanolol,Propranolol Hydrochloride,Rexigen,AY 20694,AY20694,Hydrochloride, Propranolol
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D002304 Cardiac Pacing, Artificial Regulation of the rate of contraction of the heart muscles by an artificial pacemaker. Pacing, Cardiac, Artificial,Artificial Cardiac Pacing,Artificial Cardiac Pacings,Cardiac Pacings, Artificial,Pacing, Artificial Cardiac,Pacings, Artificial Cardiac
D005260 Female Females
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013406 Suicide, Attempted The unsuccessful attempt to kill oneself. Parasuicide,Suicide Attempt,Attempt, Suicide,Attempted Suicide,Parasuicides

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