Diltiazem-induced Transient Complete Atrioventricular Block in an Elderly Patient with Acute on Chronic Renal Failure



Jorge A Brenes* , Yong-Mei Cha
Department of Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA


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© Brenes and Cha; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester MN, USA; Tel: 507-261-4644; Fax: 888-664-1253; E-mail: brenessalazar.jorge@mayo.edu


Abstract

Diltiazem is a calcium channel blocker commonly used in the treatment of various cardiovascular disorders such as hypertension, angina and supraventricular tachycardias. Metabolism occurs mainly in the liver, but a small percentage of unchanged drug and metabolites are excreted in the urine. Toxicity from this medication usually presents in the form of dysrrhytmias and heart block. Hence, we present a case of complete atrioventricular AV block in a patient receiving sustained- release diltiazem on a chronic basis. Risk factors such as advanced age and impaired renal function are dis-cussed.

Keywords: diltiazem, AV block, renal failure..