Highlights the potential for unusual electrocardiographic changes in patients presenting with combined propranolol and diltiazem overdose.
Clinicians should consider combined propranolol-diltiazem toxicity with atypical ECG changes; this Level 5 case leaves broader patterns and management implications open.
The therapeutic efficacy and safety of beta-adrenoreceptor-blocking drugs has been well established in patients with angina pectoris, cardiac arrhythmias, and hypertension and reducing the risk of mortality and nonfatal reinfarction on survival of acute myocardial infarction. The calcium antagonists are used for the treatment of patients with angina pectoris, long-term systemic hypertension, and the management of hypertensive emergencies and also for a multitude of other cardiovascular and noncardiovascular conditions. Because adverse cardiovascular effects can occur, however, patients being considered for combination treatment with propranolol and diltiazem must be selected carefully and observed closely. In this article, we present a suicidal case of drug overdose with propranolol and diltiazem with unusual electrocardiographic changes.
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Satar et al. (2003) studied this question.
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