Cardiogenic shock associated with calcium-channel and beta blockers: reversal with intravenous calcium chloride

Am J Emerg Med. 1985 Jul;3(4):334-6. doi: 10.1016/0735-6757(85)90060-9.


Two cases in which oral ingestion of beta blocker and slow calcium-channel blocker was associated with profound hypotension and bradycardia are reported, including one case in which serum levels of both drugs were documented in the normal range at a time of severe clinical toxicity. Though unresponsive to usual therapeutic interventions, both patients showed an immediate and dramatic response to intravenous calcium chloride. It is recommended that intravenous calcium chloride be considered in any patient using routine doses of these two agents who presents with hypotension and/or bradycardia.

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects*
  • Adult
  • Aged
  • Atenolol / adverse effects
  • Atenolol / blood
  • Atenolol / poisoning
  • Calcium Channel Blockers / adverse effects*
  • Calcium Chloride / blood
  • Calcium Chloride / therapeutic use*
  • Digoxin / therapeutic use
  • Diltiazem / adverse effects
  • Female
  • Humans
  • Isoproterenol / therapeutic use
  • Male
  • Shock, Cardiogenic / chemically induced*
  • Shock, Cardiogenic / drug therapy
  • Verapamil / blood
  • Verapamil / poisoning


  • Adrenergic beta-Antagonists
  • Calcium Channel Blockers
  • Atenolol
  • Digoxin
  • Verapamil
  • Diltiazem
  • Isoproterenol
  • Calcium Chloride