Citation

Ghatak A, Farrer M. J. Cardiovasc. Med. (LWW) 2009; 10(8): 649-653.

Affiliation

Ucon Health Center, Hartford, Connecticut, USA. abhijitghatak@yahoo.com

Copyright

(Copyright © 2009, Lippincott Williams and Wilkins)

DOI

10.2459/JCM.0b013e32832a1de7

PMID

19451833

Abstract

We present a rare case of a 13-year-old girl who took an intentional mixed overdose of nicorandil, lisinopril and metoclopramide. This is the first reported case in the literature of nicorandil overdose in the paediatric age group. The chief presenting clinical signs were hypoxia, peripheral hypoperfusion and hypotension with tachycardia unresponsive to aggressive intravenous volume expansion. Subsequent ECG changes suggested evolving myocardial ischaemia and were accompanied by complaints of back pain and worsening shortness of breath. Vasopressor therapy led to an immediate resolution of the ECG changes and improved the hypotension. This was continued for a further 24 h, until haemodynamic stability was achieved.

Language: en