Calcium Channel Blocker Toxicity Differential Diagnoses

Updated: Jul 14, 2017
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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DDx

Diagnostic Considerations

The conditions listed below should be considered in the differential diagnosis of calcium channel blocker (CCB) toxicity.

The following are the main common toxicity-causing agents:

  • Ingestion of beta-blocking agents
  • Acute or chronic digoxin toxicity
  • Ingestion of clonidine or other central alpha-2 agonists
  • Ingestion of any plants containing digoxinlike compounds or other cardiotoxins (eg, grayanotoxin, oleander, foxglove)
  • Opioid toxicity
  • Ingestion of any sedative hypnotics, including benzodiazepines, barbiturates, and nonbarbiturate sedative hypnotics

Other medical conditions to be considered may include the following:

  • Head trauma with Cushing reflex
  • Pontine hemorrhage
  • Septicemia
  • Septic shock
  • Spinal shock
  • Typhoid
  • Allergic reaction
  • Trauma resulting in tamponade and tension pneumothorax
  • Respiratory arrest (infants)
  • Bacterial pericarditis
  • Viral pericarditis

Differentials

Head Trauma

Hypothermia, Circulatory Arrest and Cardiopulmonary Bypass

Hypothyroidism

Lactic Acidosis

Myocardial Infarction

Pericarditis, Constrictive

Plant Poisoning, Glycosides

Shock, Cardiogenic

Toxicity, Antidepressant

Toxicity, Antidysrhythmic

Toxicity, Beta-blocker

Toxicity, Clonidine

Toxicity, Digitalis

Toxicity, Ethanol