Successful use of extended cardiopulmonary resuscitation followed by extracorporeal oxygenation after venlafaxine-induced takotsubo cardiomyopathy and cardiac arrest: a case report

Background Severe venlafaxine intoxication may cause arrhythmias, cardiac failure, and even cardiac arrest. Case presentation A 48-year-old caucasian male with an extensive psychiatric history ingested a high dose of venlafaxine causing a serum venlafaxine concentration of 12.6 mg/L 24 hours after i...

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Bibliographic Details
Published in:Journal of medical case reports 2021-09, Vol.15 (1), p.1-485, Article 485
Main Authors: Forsberg, Sune, Abazi, Lis, Forsman, Pär
Format: Article
Language:English
Subjects:
Anesthesia
Antidepressants
Blood pressure
Cardiac arrest
Cardiomyopathy
Cardiopulmonary resuscitation
Case Report
Case reports
Catecholamines
CPR
CPR (First aid)
Creatinine
ECMO
Electrocardiography
Extracorporeal membrane oxygenation
Glasgow Coma Scale
Heart diseases
Intensive care
Intoxication
Laboratories
Remifentanil
Seizures (Medicine)
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Summary:Background Severe venlafaxine intoxication may cause arrhythmias, cardiac failure, and even cardiac arrest. Case presentation A 48-year-old caucasian male with an extensive psychiatric history ingested a high dose of venlafaxine causing a serum venlafaxine concentration of 12.6 mg/L 24 hours after ingestion. Seven hours post-ingestion, he experienced tonic-clonic seizures, and 8 hours later, takotsubo cardiomyopathy was recognized followed by cardiac arrest. The patient was resuscitated with prolonged cardiopulmonary resuscitation including ongoing automatic external compressions during helicopter transportation to a tertiary hospital for extracorporeal membrane oxygenation treatment. Despite a cardiopulmonary resuscitation duration of 2 hours, 36 hours of extracorporeal membrane oxygenation, and a total of 30 days of intensive care, the patient made a full recovery. Conclusion In cases of intoxication-induced cardiac arrests among otherwise young and healthy patients, prolonged cardiopulmonary resuscitation and extracorporeal circulation can be a life-saving bridge to recovery. Keywords: Cardiac arrest, Intoxication, ECMO, CPR
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-021-03031-w