Muhammad Usman Ghani.
Vasogenic Shock Secondary to an Intentional Overdose of Multiple Antihypertensives in a patient with Hypertrophic Cardiomyopathy.
South Asian J Emerg Med Jan ;2(1):40-2.

Hypotension in patients with Hypertrophic Cardiomyopathy (HCM) can be difficult to manage as increasing blood pressure through inotropes can worsen the left ventricular outflow tract obstruction. An overdose of multiple antihypertensives can further complicate matters regarding the treatment options. We report a case of a young male with a history of hypertrophic cardiomyopathy who presented to the emergency department with an intentional overdose of multiple antihypertensives. He had persistent hypotension irrespective of fluid resuscitation and inotropic support. High dose insulin euglycemic therapy (HIET) was commenced followed by Intralipid infusion but had no improvement. Withdrawal of adrenaline infusion and switching to vasopressin improved the hemodynamics and patient was discharged eventually with full recovery.

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