Acute Inhalant-Induced Atrial Fibrillation With Severe Hypocalcemia: A Case Report and Review of the Pathophysiology

Abstract

The recreational use of inhalants is associated with various detrimental health effects ranging from inebriation to cardiac arrest. It also presents a challenging clinical problem as the diagnosis is made by the presentation and patient's history, which is often difficult to obtain in an intoxicated or obtunded individual. The incidence of inhalant use is relatively high. National surveys have reported that nearly 21.7 million Americans aged 12 and older have used inhaled substances at least once in their lives. There is no reversal agent or antidote for inhalants and supportive care is generally recommended. We present a case of a young patient presenting with acute inhalant toxicity accompanied by atrial fibrillation with a rapid ventricular response and severe hypocalcemia.

Keywords: atrial fibrillation; difluoroethane; emergency medicine; hypocalcemia; illicit substances; inhalant abuse; toxicology.

Figure 1. (A) EKG three years prior to presentation demonstrating sinus rhythm. (B) EKG at time of presentation demonstrating atrial fibrillation with rapid ventricular response. (C) EKG done four hours after presentation demonstrating return to normal sinus rhythm.