Key result
Intravenous propranolol resolves polymorphic broad complex tachycardia induced by a 5000 mg caffeine overdose.
Case Report (n=1)
Intravenous propranolol successfully treated life-threatening polymorphic broad complex QRS tachycardia induced by a massive accidental caffeine overdose.
Severe caffeine intoxication at 5 g doses warrants supplement caution; leaves open prospective toxicity threshold studies.
Caffeine (1,3,7-trimethylxanthine) is a natural product commonly presented in food's composition, beverages and medicinal products. Generally, it is thought to be safe under normal dosage, yet it can be fatal in case of severe intoxication. We report a case of a healthy 32-year-old woman who went to the local emergency department (ED) 30 min after ingesting, accidentally, 5000 mg of anhydrous caffeine for a preworkout supplement. At the ED, she presented an episode of presyncope followed by agitation. ECG showed polymorphic broad complex QRS tachycardia and arterial blood gas revealed metabolic acidaemia with severe hypokalemia. The dysrhythmia was successfully treated with intravenous propranolol. Acid-base and hydroelectrolytic disorders were also corrected. A persistent sinus tachycardia was observed in the first 2 days in the ward and 5 days later she was discharged asymptomatic with internal medicine follow-up.
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Andrade et al. (2018) conducted a case report in Caffeine overdose (n=1). Anhydrous caffeine was evaluated. Accidental ingestion of 5000 mg of anhydrous caffeine caused polymorphic broad complex QRS tachycardia and metabolic acidaemia, successfully treated with intravenous propranolol.
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