Citation

Andrade A, Sousa C, Pedro M, Fernandes M. BMJ Case Rep. 2018; 2018: e224185.

Affiliation

Department of Internal Medicine, Centro Hospitalar Barreiro Montijo EPE, Barreiro, Portugal.

Copyright

(Copyright © 2018, BMJ Publishing Group)

DOI

10.1136/bcr-2018-224185

PMID

29884665

Abstract

Caffeine (1,3,7-trimethylxanthine) is a natural product commonly presented in food's composition, beverages and medicinal products. Generally, it is thought to be safe under normal dosage, yet it can be fatal in case of severe intoxication. We report a case of a healthy 32-year-old woman who went to the local emergency department (ED) 30 min after ingesting, accidentally, 5000 mg of anhydrous caffeine for a preworkout supplement. At the ED, she presented an episode of presyncope followed by agitation. ECG showed polymorphic broad complex QRS tachycardia and arterial blood gas revealed metabolic acidaemia with severe hypokalemia. The dysrhythmia was successfully treated with intravenous propranolol. Acid-base and hydroelectrolytic disorders were also corrected. A persistent sinus tachycardia was observed in the first 2 days in the ward and 5 days later she was discharged asymptomatic with internal medicine follow-up.

© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Language: en

Keywords

arrhythmias; poisoning; vitamins and supplements