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LETTER TO THE EDITOR
Year : 2015  |  Volume : 8  |  Issue : 1  |  Page : 120  

Electrocardiographic T wave changes due to metamizol intoxication


1 Department of Internal Medicine, F?ndıklı State Hospital, Rize, Turkey
2 Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
3 Department of Internal Medicine, Taslıçay State Hospital, Ağrı, Turkey
4 Sakarya University Faculty of Medicine, Sakarya, Departments of Cardiology, Turkey
5 Sakarya University Faculty of Medicine, Sakarya, Turkey

Date of Web Publication8-Jan-2015

Correspondence Address:
Selcuk Yaylaci
Department of Internal Medicine, F?ndıklı State Hospital, Rize
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.148875

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How to cite this article:
Yaylaci S, Osken A, Genc AB, Tamer A, Gunduz H. Electrocardiographic T wave changes due to metamizol intoxication. Med J DY Patil Univ 2015;8:120

How to cite this URL:
Yaylaci S, Osken A, Genc AB, Tamer A, Gunduz H. Electrocardiographic T wave changes due to metamizol intoxication. Med J DY Patil Univ [serial online] 2015 [cited 2024 Mar 28];8:120. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2015/8/1/120/148875

Sir,

Metamizol has analgesic, antipyretic and antispasmodic effects. Nausea, vomiting, abdominal pain, renal dysfunction and rare central nervous system symptoms and cardiac arrhythmias can be seen after an acute overdose. In this article, we present a case with T-wave changes seen in his electrocardiogram (ECG) after consumption of high-dose metamizol.

A 17-year-old male patient was admitted to our emergency department approximately 2 h after taking the drugs (metamizol 500 mg, 20 pieces) to commit a suicide, with nausea and vomiting symptoms. His medical history was unremarkable. His overall condition was well; he was conscious, arterial blood pressure: 120/80 mm/Hg, pulse: 76/min., body temperature was 36.6°C. The system examination was unremarkable. The patient underwent gastric lavage and carbon was administered through nasogastric probe. Parenteral fluid therapy was applied. Laboratory tests were within normal limits. ECG monitoring was initiated. ECG was at normal sinus rhythm and there was no ST-T changes [Figure 1]. T-wave changes [Figure 2] were identified at the V1-V4 derivations in the ECG taken at the 8 th h of the follow-up; he had no chest pain and there was no pathological elevation in the cardiac enzyme controls. Echocardiographic examination was within normal limits. There was no change in ECG on the 3 rd day of the follow-up [Figure 3]. The patient recovered uneventfully and was discharged by recommending a psychiatric out-patient clinic control, after an average 72 h of follow-up.
Figure 1: Electrocardiogram was at normal sinus rhythm and there was no ST-T change

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Figure 2: T-wave changes were found at the V1-V4 derivations in the electrocardiogram taken at the 8th h of the follow-up

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Figure 3: There was no change in electrocardiogram on the 3rd day of the follow-up

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Metamizol administration may cause hypotensive reactions. This reaction probably is dose dependent. Due to this well-known side-effect blood pressure was monitored frequently. As a result, no hypotensive episodes were detected. As a conclusion ECG monitoring should be performed, since, there may be cardiac side-effects due to high dose consumption of metamizol.


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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