NDLI: Cardiogenic shock due to acute tramadol intoxication

Content Provider	Springer Nature Link
Author	Perdreau, Elodie Iriart, Xavier Mouton, Jean Baptiste Jalal, Zakaria Thambo, Jean Beît
Copyright Year	2014
Abstract	Tramadol is a common analgesic, widely prescribed because of its efficiency and safety. We report the case of a 7-year-old child admitted in cardiac intensive care unit for cardiogenic shock due to tramadol intoxication. Without any past history, the child was admitted at emergency room for generalised convulsion, followed by respiratory distress. Cardiogenic shock was suspected after clinical examination and chest X-ray and confirmed by transthoracic echocardiography showing low left ventricular ejection fraction (<30 %) with pulmonary hypertension. No evidence of cardiac infarction or myocarditis was found. Tramadol intoxication was suspected because of empty tramadol tablets found near the child and later confirmed by toxicologic analysis showing high blood concentration of tramadol (>1 mg/L) and O-desmethyltramadol (>1.5 mg/L). Hemodynamic support by inotropic drug infusion and diuretics was necessary. Left ventricular function normalised after 2 days of treatment allowing drug infusion weaning. Cardiac magnetic resonance imaging performed 3 days after admission confirmed normal left ventricular ejection fraction and volumes without evidence of late gadolinium enhancement. Cardiogenic shock due to tramadol intoxication is rare but exists. Negative inotropic effect of high doses of tramadol has been suspected. Quick recovery is possible.
Starting Page	100
Ending Page	103
Page Count	4
File Format	PDF
ISSN	15307905
Journal	Cardiovascular Toxicology
Volume Number	15
Issue Number	1
e-ISSN	15590259
Language	English
Publisher	Springer US
Publisher Date	2014-05-09
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Heart Cardiac support Analgesics Cardiovascular toxicity Pharmacology/Toxicology Cardiology
Content Type	Text
Resource Type	Article
Subject	Molecular Biology Toxicology Cardiology and Cardiovascular Medicine

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