Butane-induced acute global myocardial ischemia without coronary artery pathology

Grigorov, V.; Grigorov, M.; Grigorov, Evgeni; Nocheva, Hristina

doi:10.1093/omcr/omaa118

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Several clinical patients reported in the literature have described the development of myocardial infarction, without any changes in coronary arteries (27). In all the cases in the current series, swollen intra-alveolar areas, edema, and bleeding in lung tissues were detected, consistent with the literature (1,2,6-9).…”

Section: Discussionsupporting

confidence: 90%

“…In three cases, cardiac findings, including focal mild perivascular and interstitial fibrosis areas, contraction band necrosis, and early-stage acute ischemic changes in the heart, were detected, which were consistent with findings in the literature (25)(26)(27). Again, consistent with the literature, myocardial infarction, with early-stage ischemic changes, was detected in one case, despite healthy coronary arteries (6,25,27). These findings support the view that death could have occurred as a result of respiratory depression and asphyxia due to hypoxia and heart inhibition because of vagal nerve stimulation after spraying the gas into the mouth, leading to a vasospasm.…”

Section: Discussionsupporting

confidence: 89%

“…These factors may have contributed to these deaths. In three cases, cardiac findings, including focal mild perivascular and interstitial fibrosis areas, contraction band necrosis, and early-stage acute ischemic changes in the heart, were detected, which were consistent with findings in the literature (25)(26)(27). Again, consistent with the literature, myocardial infarction, with early-stage ischemic changes, was detected in one case, despite healthy coronary arteries (6,25,27).…”

Section: Discussionsupporting

confidence: 89%

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A Case Series of Butane Intoxication Fatalities in the Southeastern Anatolia Region of Türkiye

DÜNDAR,

ALTIN

2023

Medical Records

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Aim: Volatile solvent abuse (VSA), is the third most common form of substance abuse after alcohol and cigarettes. The aim of this study was to determine the incidence of fatalities due to butane gas. Material and Methods: From 8,075 autopsies conducted in our center in Şanlıurfa, Türkiye in a 10-year period, 10 deaths were determined to be due to butane gas intoxication. Results: All the fatalities were males (mean age: 17.6 years). Friends reported chronic use of lighter gas by the fatalities prior to the incident. In contrast, close relatives stated that it was the first instance of VSA. The preferred inhalation methods were bagging (i.e., inhaling gas from a plastic bag, n=4) and direct inhalation (i.e., spraying the gas directly in the mouth, n=6). The scene of incident findings revealed more than one lighter gas cartridge at the scene in nine cases and many lighters at the scene in one case. The autopsy examinations revealed minimal grazing on the body in three cases and no traumatic findings in seven cases. Butane was detected in blood samples in all 10 cases and in lung tissue samples in eight cases. In all 10 cases, there were areas of intra-alveolar swelling, edema, and bleeding in the lungs. Conclusion: The actual incidence of VSA-related deaths is likely much higher than the number of reported cases, as our center is located near the Syrian border and has one of the highest populations of children and young people in Türkiye.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

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A Case Series of Butane Intoxication Fatalities in the Southeastern Anatolia Region of Türkiye

DÜNDAR,

ALTIN

2023

Medical Records

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“…Two patients inhaled liquefied petroleum gas, a propane/butane gas mixture. To facilitate reading, data are summarized in Table 1 for survivors 8,13–22 and Table 2 for fatalities 1–4,14,15,18,20,23–43 . Patients were predominantly males (81%) aged between 11 and 70 years (mean age ± SD, 23 ± 13 years).…”

Section: Resultsmentioning

confidence: 99%

A two‐decade review of butane toxicity as a substance of abuse

Vahabzadeh

Mégarbane

2022

Basic Clin Pharma Tox

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Butane, an aliphatic hydrocarbon with explosive and flammable properties, is widely misused especially by young people. Acting as an asphyxiant gas, butane mainly targets the central nervous and cardiovascular systems. We aimed to review butane‐attributed toxicities due to its harmful use or misuse reported in a two‐decade period. We searched English‐language publications reporting butane toxicities from 2000 up to 2021 and collected data on age, gender, route and source of exposure, country of origin, clinical presentation and outcome. Among 54 butane's harmful use/misuse cases identified in the literature, there were 11 survivors successfully discharged from the hospital. Patients were predominantly males with a mean age ± SD of 23 ± 13 years. The main route of exposure was inhalation. Manifestations were mainly cardiac and neurological. Majority of the cases were reported from Europe and Japan. To conclude, butane exposure is at risk of severe central nervous system and cardiac toxicities, which may result in a fatal outcome. Therefore, in the event of a sudden or suspicious death in a young individual, our findings suggest that butane's harmful use/misuse should be considered as a potential differential diagnosis.

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