European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We report the case of a patient who co-ingested a tricyclic antidepressant (2500 mg of doxepin) and a neuroleptic drug (3500 mg of prothipendyl). Following overdose either agent can affect the central nervous and cardiovascular systems, inducing arrhythmias, conduction disturbances and hypotension. ⋯ The clinical features and management of this combined intoxication are discussed. Treatment with sodium bicarbonate readily corrected a potentially life-threatening cardiac arrhythmia and is therefore suggested to be imperative in the treatment of these cases.
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This paper describes the rate of re-admission and the characteristics of patients who were re-admitted after having been discharged directly from the emergency department at Sahlgrenska Hospital when they presented with acute chest pain or other symptoms suggestive of acute myocardial infarction. A total of 1463 patients were admitted and directly discharged during the 15 month recruitment period, of whom 222 (15%) were re-admitted at least once and 72 (5%) were re-admitted more than once during the subsequent 6 to 21 months. However, among patients not being re-admitted, 63% reported recurrency of symptoms one year after discharge. ⋯ In conclusion, among patients who were discharged directly from the emergency department with acute chest pain, 15% were re-admitted with similar symptoms only. A minority, however, developed acute myocardial infarction. A high proportion of patients not being re-admitted had recurrency of symptoms.