Abstract
We report a case of a 66-year-old woman who had metformin-associated lactic acidosis after overdosing of zolpidem tartrate. She displayed restlessness on admission to our emergency room. Blood gas analysis showed severe lactic acidosis and she was admitted to the ICU. After 9 hours, she complained of chest pain. Apical ballooning was observed on echocardiography, and Takotsubo cardiomyopathy was suspected. Her condition resolved, and on the 9th hospital day, she was discharged from the ICU. Lactic acidosis is a rare but sometimes fatal adverse effect of metformin. In this case, respiratory failure as a result of zolpidem tartrate overdose may have induced severe lactic acidosis, which is associated with metformin. The physical stress of lactic acidosis and the psychic stress which caused suicide attempt might eventually result in Takotsubo cardiomyopathy.
