ArticleEuropean journal of case reports in internal medicine2022
Clues to Bradycardia in a Psychiatric Patient can be Revealed by Good History-Taking: A Case Report and Literature Review.
Article in European journal of case reports in internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Lithium is a medication commonly used as a mood stabilizer and can have numerous long-lasting side effects. In this case report, we aim to remind clinicians of such consequences. A 68-year-old woman with a psychiatric history presented for mild COVID-19 and developed sinus bradycardia. A permanent pacemaker was planned for her but was cancelled following good history-taking which revealed prior lithium use. The patient was found to have hyperparathyroidism and hypothyroidism, treatment of which resolved the bradycardia. This case serves to remind clinicians that history-taking remains of paramount importance as in this scenario of bradycardia in a psychiatric patient. An invasive therapeutic measure was precluded by good history-taking. There are several mechanisms by which hypothyroidism and hyperparathyroidism can induce bradycardia. COVID-19 infection can also induce bradycardia. LEARNING POINTS: Clinicians should suspect lithium as a cause in any psychiatric patient with new-onset bradycardia.Lithium can induce bradycardia either directly or even after discontinuation indirectly through hypothyroidism and/or hyperparathyroidism.Invasive measures can be avoided with adequate management of these endocrine issues.
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