Korean J Psychopharmacol.
2008 May;19(3):168-171.
Complete Heart Block due to Lithium Toxicity
- Affiliations
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- 1Department of Psychiatry, Chonbuk National University Medical School and Institute for Medical Sciences, Jeonju, Korea. chungyc@chonbuk.ac.kr
- 2Department of Psychiatry, Chonbuk National University Hospital and Research Institute of Clinical Medicine, Jeonju, Korea.
Abstract
- Lithium treatment has been associated with a wide range of cardiac complications. We observed a 53-year-old female patient who presented with complete heart block due to lithium toxicity. The patient had been diagnosed as schizoaffective disorder and had been taking a stable dose of lithium, 1,500 mg/day since January 2007. Recently, she begun a strict diet and experienced muscle weakness and lethargy a few days later. While receiving fluid therapy, she lost her consciousness and was transferred to an emergency medical center. An electrocardiogram revealed that she had complete heart block, so a temporary pacemaker was inserted immediately. After 4 days of intensive care, her heartbeat recovered spontaneously and the temporary pacemaker was removed. On the 11th day, she had sufficiently recovered and could ambulate by herself. Lithium levels were measured at 5.22 mEq/L and 0.66 mEq/L on the 1st and 4th day of treatment, respectively. This case illustrates the importance of educating patients and their relatives about the possible lithium toxicity caused by a strict diet.
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