background:organophosphates are commercially available agrochemicals for pest control, but may be abused for deliberate self-poisoning. we report a case of suicidal ingestion of dimethoate, a moderately toxic organophosphate insecticide, which can cause refractory hemodynamic instability, and the successful use of methylene blue (mb) for counteracting this complication. case presentation: an un...

The authors present an image of a middle-aged male after coronary artery bypass grafting who received intravenous methylene blue for refractory hypotension that resulted in dermal tattooing/staining of the venous vasculature of his left shoulder and left upper chest. Republished with permission from: Bhatt AM, Tripathi RS, Moran KR, Papadimos TJ. Dermal tattooing following intravenous methylene...

Methylene blue has multiple indications for use, but recently it has been shown to be useful in treating refractory hypotension. Anaphylaxis results in widespread vasodilation and hypotension. Epinephrine has been described as the drug of choice in the treatment of hypotension for anaphylaxis, but the increased heart rate may be poorly tolerated by some patients. This case report describes a 79...

Severe intraoperative hypotension has been reported in patients on angiotensin-converting enzyme inhibitors and angiotensin II receptor subtype 1 antagonists. We describe a patient on lisinopril who developed refractory intraoperative hypotension associated with increased serum tryptase level suggesting mast cell activation (allergic reaction). However, allergology workup ruled out an allergic ...

hypotension occurs during spinal anesthesia. Only one prior case has been published describing profound hypotension in a parturient with bipolar disease, controlled with lithium and risperidone, undergoing spinal anesthesia for Cesarean delivery. The patient was refractory to conventional treatment with ephedrine and iv fluids, and eventually responded to large doses of phenylephrine.2 The trea...

BACKGROUND AND OBJECTIVES Ischemic cardiomyopathy is characterized by imbalance between supply and demand of myocardial oxygen. Endoscopic transthoracic sympathectomy is a therapeutic option indicated in refractory cases. However, the patient's position on the operating table may favor ischemic coronary events triggering the Bezold-Jarisch reflex. CASE REPORT A female patient, 47 years old, w...