Serious Complex of Arrhythmias Post-Combinations of Clarithromycin and Theophylline with Marijuana Smoking in Underlying WPW Syndrome and Malignant Repolarization Pattern

Case Report | Open Access

Volume 2023 - 2 | Article ID 226 | http://dx.doi.org/10.51521/WJCRCI.2023.220120

Serious Complex of Arrhythmias Post-Combinations of Clarithromycin and Theophylline with Marijuana Smoking in Underlying WPW Syndrome and Malignant Repolarization Pattern

Academic Editor: Wendy

Received 2023-09-27
Revised 2023-10-10
Accepted 2023-10-12
Published 2023-10-16

Yasser Mohammed Hassanain Elsayed^1*

¹Critical Care Unit, Kafr El-Bateekh Central Hospital, Damietta, Egyptian Ministry of Health (MOH), Egypt

Corresponding Author: Yasser Mohammed Hassanain Elsayed, Critical Care Unit, Kafr El-Bateekh Central Hospital, Damietta, Egyptian Ministry of Health (MOH), Egypt, Email: dryaser24@yahoo.com

Citation: Elsayed Y.M.H (2023) Serious Complex of Arrhythmias Post-Combinations of Clarithromycin and Theophylline with Marijuana Smoking in Underlying WPW Syndrome and Malignant Repolarization Pattern. World J Case Rep Clin Imag. 2023 September-October; 2(2)1-4.

Copyrights: © 2023, Elsayed Y.M.H. This article is licensed under the Creative Commons Attribution-Non Commercial-4.0-International-License-(CCBY-NC) (https://worldjournalofcasereports.org/blogpage/copyright-policy). Usage and distribution for commercial purposes require written permission.

ABSTRACT

Rationale: Drug-inducing adverse reactions are sometimes critical and fatal. Interactions of drug combinations are often an unexpected and unavoidable diagnostic challenge. Both clarithromycin and theophylline may have inevitable bad events. Recreational use of marijuana has reported serious cardiovascular adverse effects. Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome due to abnormal cardiac electrical conduction through an accessory pathway that can cause life-threatening arrhythmias. Discrimination of the benign form from the malignant one of early repolarization is a diagnostic cornerstone. Malignant early repolarization may be associated with cardiac arrest and idiopathic ventricular fibrillation. Patient concerns: A young-aged, single, student, Egyptian male, heavy smoker patient was admitted to the intensive care unit with complex serious arrhythmias post-combinations of clarithromycin and theophylline with marijuana cigarette smoking. Diagnosis: Complex serious arrhythmias post-combinations of clarithromycin and theophylline, with marijuana smoking in underlying WPW syndrome and malignant repolarization pattern. Interventions: Electrocardiography, chest, oxygenation, CT and echocardiography. Outcomes: A dramatic clinical and electrocardiographic improvement post-O2 inhalation had happened. Lessons: Combinations of theophylline and clarithromycin with marijuana cigarette smoking may carry severe and dangerous arrhythmic insults. Right quick clinical and electrocardiographic diagnosis is sometimes decisive and pivotal. Drug dealing with diseases like Wolff-Parkinson-White syndrome and malignant repolarization patterns should be highly cautious.

KEYWORDS

Wolff-Parkinson-White syndrome, Repolarization pattern, Arrhythmiaa, Left bundle branch block, Atrial fibrillation, Drug interaction, Theophylline, Clarithromycin, Marijuana

Abbreviations

AF: Atrial fibrillation

CBC: Complete blood count

ECG: Electrocardiography

ICU: Intensive care unit

IV: Intravenous

LBBB: Left bundle branch block

O2: Oxygen

SGOT: Serum glutamic-oxaloacetic transaminase

SGPT: Serum glutamic-pyruvic transaminase

SHD: Structural heart disease

VR: Ventricular rate