Electrocardiac effects associated with lithium toxicity in children: An illustrative case and review of the pathophysiology

Dhiraj Singh, Akinbolaji Akingbola, Nancy Ross-Ascuitto, Robert Ascuitto

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Lithium is a potent psychotherapeutic agent that has gained wide acceptance in paediatrics, especially as adjunct treatment for severe behavioural, anxiety, and attention-deficit hyperactivity disorders, along with bipolar conditions. Its cardiac toxicity has been well-documented in adults; however, information is limited regarding lithium's effects on the heart in children. Therefore, paediatric cardiologists following-up children on lithium therapy should be cognizant of the cardiac side-effects and pathophysiology associated with this drug. In this manuscript, we used an illustrative case of a child who presented with lithium poisoning, in order to highlight adverse clinical manifestations that can arise from this medication. The cardiac cell membrane is thought to be the primary site of lithium's action. Thus, we reviewed lithium's effects on membrane electrogenic pumps and channels involved in the distribution and passage of sodium, potassium, and calcium across the sarcolemma, as these ions, and their associated currents, are the primary determinates of the action potentials underlying auto-rhythmicity and contractile activity of the heart.

Original languageEnglish (US)
Pages (from-to)221-229
Number of pages9
JournalCardiology in the Young
Volume26
Issue number2
DOIs
StatePublished - Feb 9 2015
Externally publishedYes

Keywords

  • action potential
  • cardiac
  • electrocardiogram
  • Lithium
  • toxicity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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