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

4 Citations (Scopus)

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

Fingerprint

Lithium
Pediatrics
Sarcolemma
Periodicity
Attention Deficit Disorder with Hyperactivity
Poisoning
Action Potentials
Potassium
Anxiety
Sodium
Cell Membrane
Ions
Calcium
Membranes
Therapeutics
Pharmaceutical Preparations

Keywords

  • action potential
  • cardiac
  • electrocardiogram
  • Lithium
  • toxicity

ASJC Scopus subject areas

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

Cite this

Electrocardiac effects associated with lithium toxicity in children : An illustrative case and review of the pathophysiology. / Singh, Dhiraj; Akingbola, Akinbolaji; Ross-Ascuitto, Nancy; Ascuitto, Robert.

In: Cardiology in the Young, Vol. 26, No. 2, 09.02.2015, p. 221-229.

Research output: Contribution to journalArticle

Singh, Dhiraj ; Akingbola, Akinbolaji ; Ross-Ascuitto, Nancy ; Ascuitto, Robert. / Electrocardiac effects associated with lithium toxicity in children : An illustrative case and review of the pathophysiology. In: Cardiology in the Young. 2015 ; Vol. 26, No. 2. pp. 221-229.
@article{ab38118211994fe69f08dd4bdd5752f9,
title = "Electrocardiac effects associated with lithium toxicity in children: An illustrative case and review of the pathophysiology",
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.",
keywords = "action potential, cardiac, electrocardiogram, Lithium, toxicity",
author = "Dhiraj Singh and Akinbolaji Akingbola and Nancy Ross-Ascuitto and Robert Ascuitto",
year = "2015",
month = "2",
day = "9",
doi = "10.1017/S104795111500147X",
language = "English (US)",
volume = "26",
pages = "221--229",
journal = "Cardiology in the Young",
issn = "1047-9511",
publisher = "Cambridge University Press",
number = "2",

}

TY - JOUR

T1 - Electrocardiac effects associated with lithium toxicity in children

T2 - An illustrative case and review of the pathophysiology

AU - Singh, Dhiraj

AU - Akingbola, Akinbolaji

AU - Ross-Ascuitto, Nancy

AU - Ascuitto, Robert

PY - 2015/2/9

Y1 - 2015/2/9

N2 - 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.

AB - 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.

KW - action potential

KW - cardiac

KW - electrocardiogram

KW - Lithium

KW - toxicity

UR - http://www.scopus.com/inward/record.url?scp=84955194265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84955194265&partnerID=8YFLogxK

U2 - 10.1017/S104795111500147X

DO - 10.1017/S104795111500147X

M3 - Article

C2 - 26365301

AN - SCOPUS:84955194265

VL - 26

SP - 221

EP - 229

JO - Cardiology in the Young

JF - Cardiology in the Young

SN - 1047-9511

IS - 2

ER -