Clinical Course Of A Death From Ranolazine Overdose: A Case Report

Abstract

Introduction: Ranolazine is a new medication for angina pectoris. It is usually used for refractory angina pectoris. Ranolazine overdose may cause some serious effects on heart like other cardiac medications.

Case Report: We report the case of a 21-year-old girl was brought to the emergency department because of an attempt to commit suicide with a large number of Ranolazine tablets. She went into the coma and was unresponsive to verbal and painful stimuli after two hours of admission. There was no pathological findings on brain computed tomography (CT) and Magnetic Resonance Imaging (MRI). The QT interval was 420 msec and more extended than previous measurements. The patient had three episodes of polymorphic nonsustained ventricular tachycardia (NSVT). Despite the amiodarone treatment, the NSVT evolved to polymorphic sustained ventricular tachycardia (Torsade de Pointes; TdP) and Ventricular fibrillation (VF). The patient underwent CPR and accepted as death end of the resuscitation due to asystole on the ECG.

Conclusion: Ranolazine overdose is known that may cause some serious ECG changes and seizures. But suddenly entering a coma and death has never been reported with ranolazine intoxication in literature.