Electrocardiograms, abnormal, with

Cardiovascular Cardiomegaly, myocardial ischemia, murmurs, and abnormal electrocardiogram patients with SCD have... 

Barium sulfate is used to visualize the GI tract.105 Barium sulfate should be avoided in a patient with GI obstruction. It is insoluble and nontoxic but is a soluble compound, which is toxic and may lead to death. Constipation may be detected on oral and rectal administration, and is remedied if a large amount of water is given to the patient. A barium sulfate enema causes electrocardiogram abnormalities. Pneumonitis or granuloma formation are reported during accidental aspiration into lungs. Hypersensitivity reactions also have been reported.106... 

Cardiovascular Cardiomegaly, myocardial ischemia, murmurs, and abnormal electrocardiogram patients with SCD have lower blood pressure (BP) than the normal population normal BP values for SCD should be used for diagnosis of hypertension ("relative" hypertension) heart failure usually is related to fluid overload... 

A 6-year-old girl with ADHD and pervasive developmental disorder and behavioural problems who was treated with Depakote (valproic acid) and had an abnormal electrocardiogram (ECG) with left Centro parietal spikes experienced a convulsion the day after the first administration of a methylphenidate dose. A repeat electroencephalography demonstrated continuous spike and slow wave during sleep [73 ]. 

Monitor electrocardiogram continuously in patients with cardiac abnormalities until serum potassium levels drop below 5 mEq/L (5 mmol/L) or cardiac abnormalities resolve. Evaluate serum potassium and glucose levels within 1 hour in patients who receive insulin and dextrose therapy. Evaluate serum potassium levels within 2 to 4 hours after treatment with SPS or diuretics. Repeat doses of diuretics or SPS if necessary until serum potassium levels fall below 5 mEq/L (5 mmol/L). Monitor blood pressure and serum potassium levels in 1 week in patients who receive fludrocortisone. 

The cardiac sensitization test is based on the observation that some halocarbons make the mammalian heart abnormally sensitive to epinephrine, resulting in ectopic beats and/or ventricular fibrillation, which may result in death. Effects are monitored with electrocardiograms (EKG). The dose of administered epinephrine results in blood levels that may be approximately ten times endogenous levels and is close to the threshold for inducing cardiac effects in the absence of the test chemical. 

Hoder et al. (1984) studied clonidine in seven newborn infants with neonatal narcotic abstinence syndrome and found no significant changes in blood pressure, pulse, or electrocardiograms (EKG) in any of the seven infants. One infant had a transient abnormal eye exam and two infants developed a transient mild metabolic acidosis. On follow up 4-9 months later, four infants were found to be developmentally age appropriate. However, Huisjes et al. (1986) reported that 22 children exposed in utero to clonidine as result of treatment for maternal hypertension had increased sleep disturbances and hyperactivity, compared to a control group at a mean age of 6 years. It is unclear whether these differences were a direct effect of clonidine on prenatal development. More sophisticated preclinical studies need to be done in this area. At best the level of short-term and long-term safety regarding clonidine is level C. 

Before initiating treatment, obtain a medical history and a psychiatric history. Baseline laboratory studies are also indicated if they have not already been completed as part of the initial evaluation of the patient. An evaluation for the presence of any abnormal movements is also advisable. An electrocardiogram should be considered for patients with a history of cardiac problems. 

No cardiovascular effects were observed in a group of Air Force veterans exposed to 2,3,7,8-TCDD-contaminated herbicides during the Vietnam war and examined several years post-exposure (Wolfe et al. 1985). However, a follow-up study of the Ranch Hand cohort reported increased mean diastolic blood pressure in those with current serum lipid 2,3,7,8-TCDD levels from 15 to 33.3 ppt, but not in subjects with higher 2,3,7,8-TCDD serum levels (USAF 1991). In addition, the proportion of abnormally low peripheral pulses in all Ranch Hand veterans, regardless of serum levels, was elevated relative to a comparison group. Also, arrhythmias detected on the electrocardiogram were significantly associated with 2,3,7,8-TCDD exposure, but there was no consistent dose-response relationship. 

At 72 hours after presentation, the patient experienced new-onset chest pain, described as a burning pain in the left shoulder, arm, and epigastrium. The electrocardiogram (ECG) demonstrated only nonspecific T-wave abnormalities and was not different from the one obtained at the time of her initial presentation. Normal sinus rhythm was now present. Nitroglycerin provided some relief. Based on new symptoms, along with recurring T-wave abnormalities and... 

Chlorine plant workers (382 control workers) Inha- lation and der- mal 0.006-1.42 10.9 yr (average employment) No statistically significant signs or symptoms observed on a dose-response basis, compared with 382 control workers, for abnormal chest X-rays, electrocardiograms, pulmonary function. Controls were age matched. Patil et al. 1970... 

A 52-year-old man had an abnormally prolonged QTC interval of 560 ms, with broad-based T-waves. He had taken fluoxetine 40 mg/day over the previous 3 months, before which an electrocardiogram had shown a normal QTC interval (380 ms). The fluoxetine was withdrawn, and 10 days later the QTC interval was 380 ms. His only other medication was verapamil which he had taken for 3 years for hypertension. 

A 44-year-old woman took an overdose of venlafaxine 3 g. An electrocardiogram showed sinus rhythm and incomplete right bundle branch block (32). She was monitored in an intensive care unit and 10 hours later a further electrocardiogram showed atrial fibrillation with a wide QRS complex. Both of these abnormalities resolved with sodium bicarbonate (100 ml of a 1 M solution). No further conduction disturbances were noted over the following days. 

A previously healthy 58-year-old woman whose blood concentration of thioridazine was 1480 pg/1 (usual therapeutic concentrations are up to 200 pg/1) became comatose and had muscular rigidity. An electrocardiogram showed sinus rhythm with significant QT prolongation and 1 day later evolved into a Brugada-like pattern. Over the next 72 hours, both the electrocardiogram and the clinical abnormalities resolved. 

Additional laboratory abnormalities that have been reported in children are cardiac disturbances. Prolonged QTc intervals were reported in a few children exposed to organophosphates. However, there was spontaneous resolution with no evidence of ventricular dysrhythmia on electrocardiogram (Levy-Khademi et al, 2007). 

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