Speaker Credentials
OMS-IV
Speaker Credentials
DO
College
Dr. Kiran C. Patel College of Osteopathic Medicine, DO
Medical Specialty
Internal Medicine
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
1
Abstract
INTRODUCTION: Beta-blockers are widely prescribed for managing various conditions, including hypertension, heart failure, ischemic heart disease, arrhythmias, and off-label uses for tremors, migraines, and anxiety. They are classified into cardioselective and non-cardioselective. Although generally well-tolerated with mild side effects, beta-blocker overdose can lead to severe cardiac instability and potentially fatal outcomes. CASE PRESENTATION: To illustrate, we present a 59-year-old woman who arrived at the Emergency Room with anxiety after ingesting 15 Sotalol tablets (120 mg). Per the husband, the patient exhibited paranoid ideas for the past 3 days. The review of systems was negative. Vitals on admission: Blood Pressure 128/76 mmHg, pulse 59 bpm, respiratory rate of 17 breaths/min, afebrile, and saturating 97% on room air. However, rapid response was called in the ED due to acute hypotension (Blood Pressure 57/32mmHg) and bradycardia (pulse 52 bpm). Initial EKG showed frequent premature ventricular contractions (PVC), at times occurring as diffuse couplets with non-specific ST-T wave changes. The patient was admitted to the intensive care unit on telemetry for beta-blocker intoxication, hypotension, bradycardia, and suicide attempt. The patient was Baker Acted by the Psychiatry team. Psychotropic treatment was held until cardiac stabilization. On ICU day 2, a CODE BLUE was activated due to progression from arrhythmia to asystole to Torsade de pointes and ventricular tachycardia with loss of consciousness CONCLUSION: This case study reveals an exceptional case of severe beta-blocker toxicity which required a multidisciplinary team approach in ensuring appropriate care and preventing further complications and death.
Included in
Triaging the Clinical Dilemma of A Suicidal Attempt With Sotalol Overdose Presenting with Ventricular Tachycardia, Asystole and Torsades de Pointes
INTRODUCTION: Beta-blockers are widely prescribed for managing various conditions, including hypertension, heart failure, ischemic heart disease, arrhythmias, and off-label uses for tremors, migraines, and anxiety. They are classified into cardioselective and non-cardioselective. Although generally well-tolerated with mild side effects, beta-blocker overdose can lead to severe cardiac instability and potentially fatal outcomes. CASE PRESENTATION: To illustrate, we present a 59-year-old woman who arrived at the Emergency Room with anxiety after ingesting 15 Sotalol tablets (120 mg). Per the husband, the patient exhibited paranoid ideas for the past 3 days. The review of systems was negative. Vitals on admission: Blood Pressure 128/76 mmHg, pulse 59 bpm, respiratory rate of 17 breaths/min, afebrile, and saturating 97% on room air. However, rapid response was called in the ED due to acute hypotension (Blood Pressure 57/32mmHg) and bradycardia (pulse 52 bpm). Initial EKG showed frequent premature ventricular contractions (PVC), at times occurring as diffuse couplets with non-specific ST-T wave changes. The patient was admitted to the intensive care unit on telemetry for beta-blocker intoxication, hypotension, bradycardia, and suicide attempt. The patient was Baker Acted by the Psychiatry team. Psychotropic treatment was held until cardiac stabilization. On ICU day 2, a CODE BLUE was activated due to progression from arrhythmia to asystole to Torsade de pointes and ventricular tachycardia with loss of consciousness CONCLUSION: This case study reveals an exceptional case of severe beta-blocker toxicity which required a multidisciplinary team approach in ensuring appropriate care and preventing further complications and death.