Verapamil Overdose

Report:

Sinus bradycardia 37/min

2:1 second degree AV block

1o AV block in conducted beats

Left bundle branch block

Primary T wave changes

Comment:

The lack of sinus tachycardia is very unhealthy in this situation; much of it could be ascribed to verapamil. The LBBB and the concordantly upright T waves in V4-6 imply a myocardial lesion as well, possibly related to previous period of hypoxia and hypotension.

The blood pressure normalised with calcium infusion and pacing, but the patient never regained consciousness and was allowed to die.

Below (Fig 106a) is another of his ECGs, in accelerated junctional rhythm: the QRS-T have normalised.

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