Crack Cocaine-Induced Cardiac Conduction Abnormalities Are Reversed by Sodium Bicarbonate Infusion

Carlos Henrique Miranda,Antônio Pazin-Filho

doi:10.1155/2013/396401

Abstract

We report a dramatic case of a 19-year-old man with crack cocaine overdose with important clinical complications as cardiac arrest due to ventricular fibrillation and epileptics status. During this intoxication, electrocardiographic abnormalities similar to those found in tricyclic antidepressant poisoning were observed, and they were reversed by intravenous sodium bicarbonate infusion.

Highlights

The utilization of crack cocaine is increasing around the world because this drug is inexpensive and possible to smoke
We describe a case of crack cocaine overdose with clinical presentation of cardiac arrest due to ventricular fibrillation and epileptics status in which we observed an electrocardiographic pattern similar to that found in patients with tricyclic antidepressant poisoning and high risk of complications and these alterations were reversed after sodium bicarbonate infusion
We described a case of severe crack cocaine overdose with life-threatening ventricular arrhythmias and repeated seizures in which an interesting electrocardiographic pattern

Summary

Introduction

The utilization of crack cocaine is increasing around the world because this drug is inexpensive and possible to smoke. The crack cocaine can cause serious clinical complications during intoxication. There are some descriptions of cardiac arrhythmias, myocardial ischemia and infarction, myocarditis, hypertension, sudden death, seizure, hyperthermia, psychomotor agitation, and so forth [1]. The electrocardiogram helps identify patients at high risk of cardiac and neurologic complications in some types of intoxication as tricyclic antidepressant poisoning, in which a specific electrocardiogram pattern is recognized [2]. We describe a case of crack cocaine overdose with clinical presentation of cardiac arrest due to ventricular fibrillation and epileptics status in which we observed an electrocardiographic pattern similar to that found in patients with tricyclic antidepressant poisoning and high risk of complications and these alterations were reversed after sodium bicarbonate infusion

Case Presentation

Discussion

Conclusion