Calcium Channel Blocker Toxicity Differential Diagnoses

Updated: Sep 10, 2018
  • 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