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Case Reports
. 2019 Mar 9;7(1):e22.
eCollection 2019.

Stress Cardiomyopathy (Takotsubo syndrome) Following Accidental Methadone Poisoning; Report of Two Pediatric Cases

Khatereh Dehghani  1 , Mohammad Shojaie  2 , Amir Hossein Pourdavood  3 , Mohammad Khajouei  4
Affiliations
Case Reports

Stress Cardiomyopathy (Takotsubo syndrome) Following Accidental Methadone Poisoning; Report of Two Pediatric Cases

Khatereh Dehghani et al. Arch Acad Emerg Med. .

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.

Keywords: Methadone; cardiomyopathy; case reports; pediatrics; toxicity.

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Conflict of interest statement

None of the authors have any conflict of interest to declare regarding the manuscript.

Figures

Figure 1
Figure 1
The 12-lead electrocardogram (ECG) of the first patient demonstrating tachycardia with QT interval of 440 milliseconds and ST segment elevation in aVR and T wave inversion V1, V2 and V3
Figure 2
Figure 2
The 12-lead electrocardogram (ECG) of the second patient demonstrating sinus tachycardia and prolonged QT-interval
See this image and copyright information in PMC

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