Intravenous verapamil can cause fatal cardiovascular collapse in infants with myocarditis, suggesting proven or suspected myocarditis should be a contraindication for its use.
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Fatal collapse after IV verapamil in infant myocarditis; hypothesis-generating and should not yet change practice.
A four-month-old infant with myocarditis and supraventricular tachycardia was given intravenous verapamil (0.1 mg/kg). Immediately following the dosage, the patient developed cardiovascular collapse. Aggressive, appropriate cardiopulmonary resuscitative efforts--including ventricular pacing--failed to reverse verapamil-induced decompensation. Myocarditis may have been responsible for our failure to resuscitate this infant successfully. To our knowledge, this is the first reported pediatric fatality following intravenous verapamil. We suggest that proven or suspected myocarditis should be added to the list of contraindications for intravenous verapamil therapy.
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Garland et al. (1985) studied this question.
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