Stress Cardiomyopathy (Takotsubo syndrome) Following Accidental Methadone Poisoning; Report of Two Pediatric Cases
Archives of Academic Emergency Medicine,
Vol. 7 No. 1 (2019),
1 January 2019
,
Page e22
https://doi.org/10.22037/aaem.v7i1.344
Abstract
Methadone poisoning has become more common in the pediatric population due to extensive use of methadone maintenance therapy (MMT). It is associated with decreased level of consciousness, coma, respiratory distress and cardiac intoxication. The cardiac complications have been reported to be QT prolongation, torsade de pointes, coronary artery disease, arrhythmia, stress cardiomyopathy and death. We herein report two pediatric patients with accidental methadone poisoning who developed stress cardiomyopathy and cardiac failure. The first case was a 4-yaer-old girl and the second one was an 18-month-old girl both being accidentally poisoned with methadone syrup and were brought with decreased level of consciousness. Both were diagnosed to suffer from congestive heart failure based on echocardiography. However, the first case passed away despite appropriate treatment, while the second one survived the condition and was discharged with good condition and was symptom free at 6-month follow-up.
- Methadone
- toxicity
- cardiomyopathy
- pediatrics
- case reports
How to Cite
References
Joseph H, Stancliff S, Langrod J. Methadone maintenance treatment (MMT): a review of historical and clinical issues. Mt Sinai J Med. 2000;67(5-6):347-64.
Boyer EW, McCance-Katz EF, Marcus S. Methadone and buprenorphine toxicity in children. Am J Addict. 2010;19(1):89-95.
Sharif MR, Nouri S. Clinical Signs and Symptoms and Laboratory Findings of Methadone Poisoning in Children. Iran J Pediatr. 2015;25(1):e176.
Kashani P, Safari S, Hatamabadi H, Dolatabadi AA, Manouchehrifar M, Tabrizi MD. Characteristics of Methadone Intoxicated Children Presenting to Emergency Department; a Cross Sectional Study. Emergency. 2017;5(1).
Gheshlaghi F, Izadi-Mood N, Mardani A, Piri-Ardekani MR. Dose-Dependent Effects of Methadone on QT interval in Patients under Methadone Maintenance Treatment. Asia Pacific Journal of Medical Toxicology. 2013;2(1):6-9.
Aghabiklooei A, Shadnia S, Hassanian-Moghaddam H, Zamani N. Acute respiratory distress syndrome caused by methadone syrup. Arh Hig Rada Toksikol. 2013;64(3):439-43.
Jabbehdari S, Farnaghi F, Shariatmadari SF, Jafari N, Mehregan FF, Karimzadeh P. Accidental children poisoning with methadone: an Iranian pediatric sectional study. Iran J Child Neurol. 2013;7(4):32-4.
Mayet S, Gossop M, Lintzeris N, Markides V, Strang J. Methadone maintenance, QTc and torsade de pointes: who needs an electrocardiogram and what is the prevalence of QTc prolongation? Drug Alcohol Rev. 2011;30(4):388-96.
Alinejad S, Kazemi T, Zamani N, Hoffman RS, Mehrpour O. A systematic review of the cardiotoxicity of methadone. EXCLI journal. 2015;14:577.
Chen A, Ashburn MA. Cardiac Effects of Opioid Therapy. Pain Med. 2015;16 Suppl 1:S27-31.
Jepsen F, Ryan M. Poisoning in children. Current Paediatrics. 2005;15(7):563-8.
Gibson JC, Vulliamy A. Accidental methadone poisoning in children: a call for Canadian research action. Child Abuse Negl. 2010;34(8):553-4.
Aghabiklooei A, Edalatparvar M, Zamani N, Mostafazadeh B. Prognostic factors in acute methadone toxicity: a 5-year study. J Toxicol. 2014;2014:341826.
van Gaalen FA, Compier EA, Fogteloo AJ. Sudden hearing loss after a methadone overdose. Eur Arch Otorhinolaryngol. 2009;266(5):773-4.
Lynch RE, Hack RA. Methadone-induced rigid-chest syndrome after substantial overdose. Pediatrics. 2010;126(1):e232-4.
Lemesle F, Lemesle F, Nicola W, Pierre Jonville-Bera A. First case of stress cardiomyopathy as a result of methadone withdrawal secondary to drug-drug interaction. Am J Emerg Med. 2010;28(3):387.e5-6.
Spadotto V, Zorzi A, Elmaghawry M, Meggiolaro M, Pittoni GM. Heart failure due to 'stress cardiomyopathy': a severe manifestation of the opioid withdrawal syndrome. Eur Heart J Acute Cardiovasc Care. 2013;2(1):84-7.
- Abstract Viewed: 510 times
- PDF Downloaded: 282 times
- HTML Downloaded: 71 times
