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Acute hydralazine overdose: Marked ECG abnormalities in a young adult

✍ Scribed by Brent A Smith; Douglas B Ferguson


Publisher
Elsevier Science
Year
1992
Tongue
English
Weight
589 KB
Volume
21
Category
Article
ISSN
1097-6760

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✦ Synopsis


Although hydralazine is a commonly prescribed antihypertensive agent, reports of acute human poisoning are uncommon. Most of the literature focuses on chronic toxicity, most notably, the drug-induced systemic lupus erythematosus syndrome. A case of acute hydralazine overdose associated with marked ECG ST segment depression in a young adult is presented. Although the patient also had mild hypotension, acidemia, and ethanol intoxication, the ECG abnormality was alarming and suggestive of myocardial ischemia. The patient was managed conservatively in an tCU setting, and the metabolic and ECG abnormalities resolved. No reports of such marked ECG changes associated with acute hydralazine poisoning in a young adult could be found. Clinical and experimental data on acute hydralazine exposure suggest that the possibility of direct drug effects, including positive inotropic and chronotropic effects and myocardial cell injury, should be considered. [Smith BA, Ferguson DB: Acute hydralazine overdose: Marked ECG abnormalities in a young adult.