8/16/2023 0 Comments Caffeine half life pre teensOn follow-up examination in cardiology clinic one month later, the patient had a normal cardiac examination, a normal ECG, and no further symptoms of arrhythmia.Ī 16-year-old Caucasian boy with a history of attention-deficit hyperactivity disorder, asthma, and allergies presented to the emergency department with intoxication and vomiting after falling and sustaining minor head trauma. He was treated with one dose of digoxin as a partial load at 7.5 μg/kg and quickly converted to normal sinus rhythm with a heart rate of 70 to 80 beats per minute (Figure (Figure2). Cardiac ECG revealed a structurally normal heart without thrombus. His electrocardiogram (ECG) showed narrow-complex tachycardia with atrial fibrillation and occasional atrial flutter (Figure (Figure1). Thyroid-function tests and serum calcium were normal. His physical examination revealed an irregularly irregular heart rate at approximately 130 beats per minute with a 1/6 vibratory systolic ejection murmur at the left lower sternal border. He also reported drinking a Red Bull™ energy drink five days before admission and feeling the same fluttering sensation. He denied recent illness and denied drug ingestion, but reported drinking an unknown quantity of a highly caffeinated drink the day before. We report two cases of atrial fibrillation in healthy adolescent boys after the consumption of energy drinks.Ī 14-year-old Caucasian boy with no significant past medical history presented with persistent "heart fluttering" two hours after a running race. This case series describes the possible association between the consumption of highly caffeinated drinks and the development of cardiac arrhythmias, specifically atrial fibrillation, in the adolescent population. Įnergy drinks and highly caffeinated drinks comprise some of the fastest-growing products of the beverage industry, often targeting teenagers and young adults. The physiologic and psychological effects of caffeine have been studied in adults but have not been systematically analyzed in children. The population as a whole has variable sensitivity to the stimulant effects of caffeine one's tolerance and dependence on caffeine seem to be somewhat heritable and may be linked to genetic polymorphisms. The US Food and Drug Administration deems, "caffeine is generally recognized as safe when used in cola-type beverages up to a level of 0.02 percent". Long-term consumption of caffeine or consumption of large amounts of caffeine will prolong its half-life. The half-life of caffeine in a normal healthy adult is estimated to be from 2.5 to 10 hours, depending on the individual. Caffeine causes central and peripheral nervous system stimulation through antagonism of adenosine receptors and also has dopaminergic properties, which lend to its addictive potential. Ĭaffeine is a natural stimulant found in tea leaves, coffee beans, and cacao, and is one of the most popular psychoactive substances used today. Another case report described a 58-year-old man with atrial fibrillation and a dilated cardiomyopathy, which resolved when he discontinued his excessive caffeine consumption. A recent case report outlined a correlation between prolonged inhaled salbutamol and concurrent chocolate abuse, leading to an atrial arrhythmia in an adult, postulating that the caffeine in the chocolate coupled with the short-acting beta agonist triggered the arrhythmia. A controlled trial of escalating doses of caffeine in dogs surprisingly found that serum caffeine actually decreased the propensity for atrial fibrillation another canine trial demonstrated an increase in cardiac arrhythmias with high doses of caffeine administered. A large-scale Danish study evaluating adult human caffeine consumption and arrhythmias did not find a higher risk of atrial fibrillation or flutter with variable oral consumption of caffeine from everyday sources. Įxogenous causes of atrial fibrillation through a substrate such as caffeine have not been widely reported in the literature, especially in the pediatric population. Without a prior cardiac or family history, other inciting causes such as thyrotoxicosis, infectious pericarditis, and pulmonary emboli should be considered in the previously healthy child presenting with new-onset atrial fibrillation. The ventricular response is often irregularly irregular. The electrocardiogram is characterized by disorganized atrial activity without discrete P waves. Patients may present with palpitations, dyspnea, fatigue, light-headedness, or syncope. Atrial fibrillation is extremely rare in the pediatric population, almost always occurring in association with structural heart disease, such as rheumatic mitral valve disease, congenital heart disease with dilated atria, and rarely, as a complication of intra-atrial surgery.
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