Muñiz Antonio E
Mesquite, Texas.
J Emerg Med. 2017 Sep;53(3):333-338. doi: 10.1016/j.jemermed.2016.07.017.
Valproic acid (VPA) is increasingly used to treat a variety of medical disorders, such as seizures, psychiatric disorders, and headaches. Therefore, accidental and intentional ingestions with valproic acid are increasing.
A case is presented in an adolescent with ischemic electrocardiographic changes after an acute overdose with VPA.
Major features of a valproic acid overdose include respiratory depression, progressive coma, hepatotoxicity, thrombocytopenia, and hemodynamic instability. Electrocardiographic abnormalities usually consist of tachycardia and nonspecific changes. Supportive care is indicated in most overdoses and involves the monitoring and correction of electrolyte abnormalities, coagulopathies, and acid-base imbalances. Treatment may include activated charcoal, naloxone, l-carnitine, and extracorporeal detoxification.
Valproic acid overdose is a relatively rare and electrocardiographic changes usually consist of tachycardia and nonspecific changes, but ischemic changes may occur and usually transient and require only recognition.
丙戊酸（VPA）越来越多地用于治疗各种医学病症，如癫痫、精神疾病和头痛。因此，丙戊酸的意外和故意摄入正在增加。
本文介绍了一例青少年在急性过量服用VPA后出现缺血性心电图改变的病例。
丙戊酸过量的主要特征包括呼吸抑制、进行性昏迷、肝毒性、血小板减少和血流动力学不稳定。心电图异常通常包括心动过速和非特异性改变。大多数过量病例需要支持性治疗，包括监测和纠正电解质异常、凝血障碍和酸碱失衡。治疗可能包括活性炭、纳洛酮、左旋肉碱和体外解毒。
丙戊酸过量相对罕见，心电图改变通常包括心动过速和非特异性改变，但可能出现缺血性改变，通常是短暂的，仅需识别即可。
