IMAGES IN EMERGENCY MEDICINE
Amiodarone induced thrombophlebitis
Department of Cardiology, St Bartholomew’s Hospital, West Smithfield, London, UK
Correspondence to:
Correspondence to:
Refai Showkathali
Department of Cardiology, St Bartholomew’s Hospital, West Smithfield, London, UK; refais@gmail.com
| The first 150 words of the full text of this article appear below. |
Thrombophlebitis of peripheral vein is a well recognised complication of intravenous amiodarone use in high doses (300–1200 mg) or prolonged infusion. This case demonstrates that even smaller doses of amiodarone can cause significant thrombophlebitis, if given in a small vein.
A 79-year-old man presented to his local emergency department with haemodynamically stable ventricular tachycardia. Amiodarone, 150 mg, was given via a 20-gauge cannula into a small vein on the dorsum of his left hand. Figure 1
, a photograph of the hand, was taken 72 h after his original admission and shows severe amiodarone induced thrombophlebitis. Although thrombophlebitis is a well recognised complication of intravenous amiodarone, this is usually caused by high doses (300–1200 mg) or prolonged administration in a peripheral vein. A meta-analysis of 18 randomised controlled trials studying intravenous amiodarone to convert atrial fibrillation reported a rate of 8% of phlebitis among the 550 patients who received amiodarone.1
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Figure 1 | |||||||||
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