Advertisement

‘Silent’ Prinzmetal’s ST Elevation Related to Atenolol Overdose

      Abstract

      Prinzmetal’s angina is a condition characterized by chest pain, transient ST elevation, and negative biochemical markers of myocardial cell necrosis. We describe a case of chemically-induced “silent” ST segment elevation related to Atenolol overdose in a patient without coronary artery stenosis. We conclude that the cause for the transient myocardial ischemia is coronary vasospasm, precipitated by beta-blocker overdose.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Megarbane B.
        • Karyo S.
        • Baud F.J.
        The role of insulin and glucose (hyperinsulinaemia/euglycaemia) therapy in acute calcium antagonist and beta-blocker poisoning.
        Toxicol Rev. 2004; 23: 215-222
        • Wax P.M.
        • Erdman A.R.
        • Chyka P.A.
        • et al.
        β-blocker ingestion: an evidence-based consensus guideline for out-of-hospital management.
        Clin Toxicol. 2005; 43 (Phila): 131-146
        • De Witt C.R.
        • Waksman J.C.
        Pharmacology, pathophysiology and management of calcium channel blockers and beta-blocker toxicity.
        Toxicol Rev. 2004; 23: 223-238
        • Love J.N.
        • Howell J.M.
        • Litovitz T.L.
        • Klein-Schwartz W.
        Acute beta-blocker overdose: factors associated with the development of cardiovascular morbidity.
        J Toxicol Clin Toxicol. 2000; 38: 275-281
        • Spinello I.M.
        • Dellinger R.P.
        Management of poisoning and overdose in the intensive care unit.
        Clin Pulm Med. 2002; 9: 213-220
        • Vandergoten P.
        • Benit E.
        • Dendale P.
        Prinzmetal’s variant angina: three case reports and a review of the literature.
        Acta Cardiol. 1999; 54: 71-76
        • Keller K.B.
        • Lemberg L.
        Prinzmetal’s angina.
        Am J Crit Care. 2004; 13: 350-354
        • Love J.N.
        • Enlow B.
        • Howell J.M.
        • Klein-Schwartz W.
        • Litovitz T.L.
        Electrocardiographic changes associated with beta-blocker toxicity.
        Ann Emerg Med. 2002; 40: 603-610
        • Cheng T.O.
        • Yasue H.
        Coronary artery spasm.
        in: Cheng T.O. The international textbook of cardiology. Pergamon, New York1987: 621-637
        • Pitts W.R.
        • Lange R.A.
        • Cigarroa J.E.
        • Hillis L.D.
        Cocaine-induced myocardial ischemia and infarction.
        Prog Cardiovasc Dis. 1997; 40: 65-76
        • Opie L.H.
        Mechanisms whereby calcium channel antagonists may protect patients with coronary artery disease.
        Eur Heart J. 1997; 18: A92-A104
        • Ardissino D.
        • Savonitto S.
        • Mussini A.
        • et al.
        Felodipine (once daily) versus nifedipine (four times daily) for Prinzmetal’s angina pectoris.
        Am J Cardiol. 1991; 68: 1587-1592
        • Lin Y.J.
        • Liu Y.B.
        • Wu C.C.
        • Chen W.J.
        • Lee Y.T.
        Painless Prinzmetal’s ST elevation related to propranolol: a case report.
        Int J Cardiol. 1997; 60: 311-314