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The peripheral autonomic nervous system, central nervous system and the heart are the main systems that are affected following overdose. [1] Initial or mild symptoms typically develop within 2 hours and include tachycardia, drowsiness, a dry mouth, nausea and vomiting, urinary retention, confusion, agitation, and headache. [7]
People usually present with atrial fibrillation; however, other forms of arrhythmia may be developed, such as atrial tachycardia, premature ventricular contraction, and atrial flutter. Patients with HHS also frequently report precordial pain , sweating , anxiety , shortness of breath , and syncope .
There are several known causes of adrenergic storms; in the United States, cocaine overdose is the leading cause. [16] Any stimulant drug has the capacity to cause this syndrome if taken in sufficient doses, but even non-psychotropic drugs can very rarely provoke a reaction.
This person was eventually diagnosed with tachycardia-induced cardiomyopathy. [7] There are no specific diagnostic criteria for TIC, and it can be difficult to diagnose for a number of reasons. First, in patients presenting with both tachycardia and cardiomyopathy, it can be difficult to distinguish which is the causative agent. [5]
Secondary causes of sinus tachycardia must be ruled out and corrected if present. A full endocrinology evaluation for disease entities such as hyperthyroidism, pheochromocytoma, and diabetes mellitus with evidence of autonomic dysfunction should be included in the evaluation for inappropriate sinus tachycardia. [10]
CCBs of the dihydropyridine group, as well as flunarizine, predominantly cause reflex tachycardia as a reaction to the low blood pressure. [4] [5] [6] Other potential symptoms include: nausea and vomiting, a decreased level of consciousness, and breathing difficulties. [2] Symptoms usually begin within 6 hours of taking the medication by mouth. [2]
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Complications include hypertension and tachycardia. Substances that may cause this toxidrome include cocaine, amphetamine and compounds based upon amphetamine's structure such as ephedrine , methamphetamine, phenylpropanolamine and pseudoephedrine. The bronchodilator salbutamol may also cause this toxidrome. It may appear very similar to the ...