Volume 7, Issue 23 (Winter 2014)                   IJT 2014, 7(23): 952-955 | Back to browse issues page

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Kazemzadeh N, Mohammadi S, Emamhadi M, Amirfarhangi A, Sanaei-Zadeh H. Electrocardiographic Manifestations of Benzodiazepine Toxicity. IJT. 2014; 7 (23) :952-955
URL: http://ijt.arakmu.ac.ir/article-1-268-en.html
Department of Forensic Medicine and Toxicology, Iran University of Medical Sciences, Tehran, Iran.‎ , drsm1980@gmail.com
Abstract:   (4412 Views)
Background: The aim of this study was to evaluate and compare the clinical and ‎electrocardiographic (ECG) manifestations of benzodiazepines (BZs).‎
Methods: In this retrospective study, all BZ-poisoned patients hospitalized at Loghman ‎Hakim Hospital between September 2010 and March 2011 were evaluated. Patients’ ‎information including age, sex, time elapsed between the ingestion and presentation, ‎and type of the BZ used were extracted from the patients' charts and recorded. ECGs ‎on presentation to the emergency department (ED) were evaluated and parameters ‎such as PR interval, QRS duration, corrected QT, amplitude of S wave in lead I, height ‎of R wave and R/S ratio in the lead aVR were also measured and recorded.‎
Results: Oxazepam, chlordiazepoxide, lorazepam, alprazolam, diazepam, and ‎clonazepam were ingested by 9 (3%), 13 (4.4%), 29 (9.9%), 105 (35.8%), 65 (22.2%), ‎and 72 (24.6%) patients, respectively. Mean PR interval was reported to be 0.16 ± 0.03 ‎sec and PR interval of greater than 200 msec was detected in 12 (4.5%) patients. Mean ‎QRS duration was 0.07 ± 0.01sec and QRS≥120 msec was observed in 7 (2.6%) ‎cases. ‎
Conclusion: Diazepam is the only BZ that does not cause QRS widening and ‎oxazepam is the only one not causing PR prolongation. It can be concluded that if a ‎patient refers with a decreased level of consciousness and accompanying signs of BZ ‎toxicity, QRS widening in ECG rules out diazepam, whereas PR prolongation rules out ‎oxazepam toxicity.‎
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Type of Study: Research | Subject: Special

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