Waring W Stephen, Wallace William A H
Scottish Poisons Information Bureau, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
Eur J Clin Pharmacol. 2007 Nov;63(11):1007-9. doi: 10.1007/s00228-007-0360-y. Epub 2007 Sep 7.
Monoamine oxidase inhibitors (MAOIs) are uncommonly used due to their high frequency of adverse effects, including tachycardia and hypertension. Recently, there has been renewed interest in the role of this class of drugs in treating a variety of psychiatric disorders. The clinical features of MAOI overdose are poorly characterised. This paper describes a novel cardiac complication of phenelzine toxicity in a previously healthy young adult with no history of cardiovascular disease.
A 23-year-old woman presented to hospital after massive phenelzine overdose, and the clinical features and pathological findings are discussed in light of existing literature.
Clinical features of phenelzine toxicity included reduced consciousness level, seizures, and tachycardia, in keeping with previous reports. Unexpectedly, the patient developed severe and unexplained hypotension and impaired left ventricular function, and died 3 days after initial presentation. Post-mortem examination confirmed high serum phenelzine concentrations (4.1 mg/L) and histopathological features that were consistent with drug-induced acute myocarditis.
Acute myocarditis was attributed to phenelzine in the absence of any plausible alternative explanation. This possible complication should be considered in patients who develop unexplained hypotension after phenelzine overdose.
单胺氧化酶抑制剂（MAOIs）因不良反应发生率高，包括心动过速和高血压，而较少使用。最近，这类药物在治疗多种精神疾病中的作用重新引起了人们的关注。MAOI过量的临床特征尚不明确。本文描述了一名既往健康、无心血管疾病史的年轻成年人因苯乙肼中毒出现的一种新型心脏并发症。
一名23岁女性在大量服用苯乙肼后入院，结合现有文献对其临床特征和病理结果进行了讨论。
苯乙肼中毒的临床特征包括意识水平降低、癫痫发作和心动过速，与先前报道一致。出乎意料的是，患者出现了严重且无法解释的低血压和左心室功能受损，并在初次就诊3天后死亡。尸检证实血清苯乙肼浓度较高（4.1mg/L），且组织病理学特征与药物性急性心肌炎相符。
在没有任何合理替代解释的情况下，急性心肌炎归因于苯乙肼。苯乙肼过量后出现无法解释的低血压的患者应考虑这种可能的并发症。
