Cardiac Conduction Defects Induced by Paracetamol Overdose: A Rare Case

Paracetamol, also known as acetaminophen, is one of the most frequently used analgesic and antipyretic agents worldwide and is considered safe at therapeutic doses. However, in overdose situations, it is a leading cause of acute liver failure. While hepatic and renal toxicities are well documented, cardiac complications are rarely reported. We present a rare case of a 32-year-old woman who developed transient second-degree atrioventricular (AV) block following intentional ingestion of 15 grams of paracetamol. Although her liver function tests were markedly elevated and she presented with classical signs of hepatotoxicity, she also experienced bradycardia and intermittent AV block during hospitalization. With timely administration of N-acetylcysteine and supportive management, including correction of electrolyte imbalances, the conduction defects resolved without further complications. This case highlights the need to consider cardiac monitoring in patients with significant paracetamol overdose, especially those with evidence of liver dysfunction.