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An 88-year-old woman presented with a 5-day history of nausea, vomiting and abdominal pain at the emergency department. Her medical history included sick sinus syndrome and atrial flutter, for which she underwent permanent pacemaker implantation and radiofrequency catheter ablation 4 and 6 months earlier, respectively. She had been prescribed amiodarone for 5 months (600 mg/day for 2 months, then 400 mg/day for 3 months) due to relapsing atrial flutter after ablation. The level of alanine aminotransferase was 45 U/L (reference range, 0–41), total bilirubin was 0.66 mg/dL (reference range, 0.3–1.0) and direct …
Contributors LTK drafted the manuscript. MTL was involved in image preparation and revising the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Next of kin consent obtained.
Provenance and peer review Not commissioned; internally peer reviewed.
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