Historique
Périodique
Cocaine-related torsade de pointes in a methadone maintenance patient
(Torsade de pointe liée à la cocaïne chez un patient en traitement de maintenance à la méthadone.)
Auteur(s) :
KRANTZ, M. J. ;
ROWAN, S. B. ;
MEHLER, P. S.
Année
2005
Page(s) :
53-60
Langue(s) :
Anglais
Refs biblio. :
22
Domaine :
Drogues illicites / Illicit drugs
Discipline :
PAT (Pathologie organique / Organic pathology)
Thésaurus mots-clés
COCAINE
;
METHADONE
;
PATHOLOGIE ORGANIQUE
;
APPAREIL CARDIOVASCULAIRE
;
ETUDE DE CAS
Note générale :
Journal of Addictive Diseases, 2005, 24, (1), 53-60
Résumé :
A patient maintained on methadone for opioid-dependency developed recurrent syncope. Episodes occurred within hours after using cocaine, and were initially presumed secondary to seizure disorder. However, the patient subsequently suffered a cardiac arrest, and polymorphic ventricular tachycardia (torsade de pointes) was documented. Other than cocaine and methadone the patient was receiving no additional agents known to prolong the QT interval. Low serum methadone concentrations and marked reversible left ventricular systolic dysfunction were noted during the hospitalization. These findings, in conjunction with a history of torsade de pointes temporally related to cocaine abuse, suggest that cocaine was a major precipitant of arrhythmia. Recent experimental studies have shown that cocaine and methadone prolong the QT interval through the same mechanism. We examine the effects of cocaine and methadone on cardiac conduction in the context of the opioid-dependent population. (Author' s abstract)
Affiliation :
Denver Health Medical Center, Dept Medicine, Cardiology Div., Mail Code 0960, 777 Bannock Street, Denver, CO 80204-4507.
Etats-Unis. United States.
Etats-Unis. United States.