Repetitive Myocardial Infarctions Secondary to Delirium Tremens
Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medicat...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2014/638493 |
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| author | David Schwartzberg Adam Shiroff |
| author_facet | David Schwartzberg Adam Shiroff |
| author_sort | David Schwartzberg |
| collection | DOAJ |
| description | Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal. |
| format | Article |
| id | doaj-art-c71466aaba1d4d589f7d0e4b988e66e8 |
| institution | DOAJ |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-c71466aaba1d4d589f7d0e4b988e66e82025-08-20T03:22:58ZengWileyCase Reports in Critical Care2090-64202090-64392014-01-01201410.1155/2014/638493638493Repetitive Myocardial Infarctions Secondary to Delirium TremensDavid Schwartzberg0Adam Shiroff1Department of Surgery, Monmouth Medical Center, Long Branch 300 2nd Avenue, Long Branch, NJ 07760, USADepartment of Trauma & Critical Care Surgery, Jersey Shore University Medical Center, Neptune, NJ 07753, USADelirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal.http://dx.doi.org/10.1155/2014/638493 |
| spellingShingle | David Schwartzberg Adam Shiroff Repetitive Myocardial Infarctions Secondary to Delirium Tremens Case Reports in Critical Care |
| title | Repetitive Myocardial Infarctions Secondary to Delirium Tremens |
| title_full | Repetitive Myocardial Infarctions Secondary to Delirium Tremens |
| title_fullStr | Repetitive Myocardial Infarctions Secondary to Delirium Tremens |
| title_full_unstemmed | Repetitive Myocardial Infarctions Secondary to Delirium Tremens |
| title_short | Repetitive Myocardial Infarctions Secondary to Delirium Tremens |
| title_sort | repetitive myocardial infarctions secondary to delirium tremens |
| url | http://dx.doi.org/10.1155/2014/638493 |
| work_keys_str_mv | AT davidschwartzberg repetitivemyocardialinfarctionssecondarytodeliriumtremens AT adamshiroff repetitivemyocardialinfarctionssecondarytodeliriumtremens |