Serotonin Syndrome in the Intensive Care Unit Following Orthotopic Heart Transplantation: A Case Report

The diagnosis of serotonin syndrome in the ICU population is challenging due to its relative complexity and clinical unfamiliarity. Our report is based on a clinical presentation of a 64 year-old female on chronic SSRI therapy who underwent orthotopic heart transplantation (OHT), followed by hyperthermia and autonomic instability. The symptoms were related to the subsequent vasoplegic syndrome requiring methylene blue. The purported offending agents were discontinued and her symptoms improved over the next several hours. Although serotonin syndrome is uncommon and becomes a difficult diagnosis to make, clinicians need to recognize it early.