Cardiopulmonary Medicine  |   December 2020
Mobitz Type II Atrioventricular Heart Block After Candlenut Ingestion
Author Notes
  • From the Lehigh Valley Health Network, Department of Emergency and Hospital Medicine / USF Morsani College of Medicine in Allentown, Pennsylvania. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Andrew L. Koons, DO, LVH-M 4th Floor (South Wing), 2545 Schoenersville Road, Bethlehem, Pennsylvania, 18017-7300. Email: andrew.koons@lvhn.org
     
Article Information
Cardiopulmonary Medicine   |   December 2020
Mobitz Type II Atrioventricular Heart Block After Candlenut Ingestion
The Journal of the American Osteopathic Association, December 2020, Vol. 120, 839-843. doi:https://doi.org/10.7556/jaoa.2020.136
The Journal of the American Osteopathic Association, December 2020, Vol. 120, 839-843. doi:https://doi.org/10.7556/jaoa.2020.136
Abstract

The candlenut is a highly accessible seed marketed as a natural weight-loss supplement. However, there is little known about the exact mechanism of action for weight loss nor for the many adverse symptoms it causes, such as nausea, vomiting, fatigue, cardiac dysrhythmias, and even death. In this case report, the authors present a 44-year-old woman who developed a second-degree, Mobitz type II atrioventricular block after consumption of a candlenut supplement. She presented to the emergency department with syncope and her cardiac rhythm indicated a second-degree heart block soon after ingesting candlenuts recommended by her treating physician. Interestingly, a detectable digoxin concentration obtained on hospital day 2 was measured but of unclear significance given no obvious exposure to a cardioactive glycoside. The patient's rhythm normalized on hospital day 2 and she was discharged uneventfully.

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