Haemodynamic and electrocardiographic consequences of severe nicorandil toxicity

A 35 year old woman was admitted to the emergency department two hours after ingesting 60×20 mg tablets of nicorandil, total 1.2 g. The dominant feature of icorandil toxicity was profound peripheral vasodilatation associated with coronary hypoperfusion. Despite widespread electrocardiographic signs...

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Bibliographic Details
Published in:Emergency medicine journal : EMJ 2003-01, Vol.20 (1), p.98-100
Main Authors: Greenwood, J P, Malik, I, Jennings, P, Stevenson, R N
Format: Article
Language:English
Subjects:
Adult
Blood pressure
Blood Pressure - physiology
Case Report
Case studies
Coronary Disease - chemically induced
Coronary Disease - diagnosis
Coronary Disease - physiopathology
drug misuse
Electrocardiography
Emergency medicine
Heart attacks
Humans
Hypotension - chemically induced
Myocardial Ischemia - chemically induced
Myocardial Ischemia - diagnosis
Myocardial Ischemia - physiopathology
nicorandil
Nicorandil - poisoning
Nitrates
Potassium
Toxicity
Vasodilator Agents - poisoning
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Summary:A 35 year old woman was admitted to the emergency department two hours after ingesting 60×20 mg tablets of nicorandil, total 1.2 g. The dominant feature of icorandil toxicity was profound peripheral vasodilatation associated with coronary hypoperfusion. Despite widespread electrocardiographic signs of myocardial ischaemia, there was no evidence of myocardial damage and no serious cardiac arrhythmia. Volume loading and pressor support proved to be an effective treatment strategy.
ISSN:1472-0205
1472-0213
DOI:10.1136/emj.20.1.98