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A 73-year-old woman developed cardiogenic shock, haemodynamic instability and cardiac arrest due to dynamic left ventricular outflow tract obstruction (LVOTO) during treatment with escitalopram and lorazepam, as well as refractory pulse-less electrical activity (PEA) due to epinephrine [adrenaline]. She also developed lorazepaminduced haemolytic anaemia (HA).
The woman with an underlying anxiety disorder, functional headache and hypertension presented with progressively worsening headaches. Therefore, she was prescribed escitalopram and lorazepam [dosages and routes not stated]. However, her symptoms did not improve and after 4 days, she was brought to the hospital for chest and back pain with altered consciousness. On arrival, she was in cardiogenic shock with Glasgow Coma Scale score of 3/15 (E1V1M1). Both pupils were approximately 4mm in diameter and reactive. Her BP was too low to be measured. Her carotid artery pulse was palpable, with a HR of 112 beats/minute and a RR of 30 breaths/minute. Her conjunctiva was pale. An auscultation of breath sounds was within normal limits and did not reveal upper and lower airway obstructions....