BACKGROUND: Amiodarone is frequently used in emergency departments for treatment of arrhythmias. Incidence of several amiodarone-related adverse events is unknown. The literature is sparse for potentially life-threatening adverse effects of amiodarone.

CASE REPORT: We present a case of a male patient who presented with chest discomfort and rapid atrial fibrillation. He was known to have paroxysmal atrial fibrillation, which did not respond to initial beta-blocker treatment. The second-line drug amiodarone was given to the patient for rate control. He developed severe hypotension related to amiodarone and required inotropic support along with rapid-sequence intubation.

CONCLUSIONS: Intravenous amiodarone can cause severe and refractory hypotension.

Keywords: Amiodarone - adverse effects, Anti-Arrhythmia Agents - adverse effects, Atrial Fibrillation - drug therapy, Hypotension - chemically induced