A Rare Case of Junctional Bradycardia Secondary to Oral Phenytoin

Phenytoin is a commonly used anti-seizure agent, which stabilizes neuronal membranes by blocking voltage-gated sodium channels to inhibit the propagation of action potentials during convulsions. However, phenytoin has also been shown to have antiarrhythmic effects as it can prolong the effective ref...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 14; no. 5
Main Authors Niazi, Bilal A, Trivedi, Chinmay, Perrella, Benjamin
Format Journal Article
LanguageEnglish
Published Palo Alto Cureus Inc 23.05.2022
Cureus
Subjects
Blood pressure
Cardiac arrhythmia
Cardiology
Case reports
Chagas disease
Electrocardiography
Electrolytes
Epilepsy
Heart rate
Hospitals
Hypotension
Intellectual disabilities
Internal Medicine
Ischemia
Laboratories
Lyme disease
Neurology
Nursing homes
Oral administration
Serology
Sodium
Toxicity
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Summary:Phenytoin is a commonly used anti-seizure agent, which stabilizes neuronal membranes by blocking voltage-gated sodium channels to inhibit the propagation of action potentials during convulsions. However, phenytoin has also been shown to have antiarrhythmic effects as it can prolong the effective refractory period of ventricular pacemaker cells. Adverse cardiac effects such as junctional bradycardia are usually seen with intravenous use. Cardiovascular dysfunction is not well recognized in oral phenytoin toxicity. Here we present a case of junctional bradycardia due to oral phenytoin toxicity, which resolved spontaneously with the discontinuation of phenytoin. This case report will serve to increase awareness of the adverse cardiovascular effects of oral phenytoin toxicity to improve the recognition and treatment of these adverse effects.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.25251