Cardiac abnormalities in acute organophosphate poisoning

Anand, Shashi; Singh, Surjit; Saikia, Uma Nahar; Bhalla, Ashish; Sharma, Yash Paul; Singh, Dileep Kumar

doi:10.1080/15563650902724813

Cited by 73 publications

(53 citation statements)

References 18 publications

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“…Myocardial blotchiness, patchy pericarditis, subepicardial hemorrhage, and hemorrhages on the posterior aspect of the left ventricle and left atrium were observed in three cases. The authors attributed this to early myocardial toxicity, although some of these changes could have been due to attempted CPR [16].…”

Section: Discussionmentioning

confidence: 99%

Late Onset, Prolonged Asystole Following Organophosphate Poisoning: A Case Report

Chacko

Elangovan

2010

J. Med. Toxicol.

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Introduction Organophosphate (OP) compounds are commonly used as suicidal agents and produce characteristic toxic effects. Cardiac arrhythmias are often observed in the acute phase of toxicity; late onset polymorphic ventricular tachycardia preceded by prolonged QT interval on the EKG is also known to occur. However, there are no reports of late onset, prolonged asystole without preceding arrhythmias and after acute toxicity had abated. Case Report We report a case of prolonged asystole 12 days after ingestion of an OP compound, after apparent recovery from the acute toxic effects. Asystole persisted for 25 min, followed by successful resuscitation without any sequelae. Discussion Although cardiac arrhythmias and circulatory arrest are known to occur following OP ingestion, these are often in the acute phase of toxicity. Our patient had no preceding cardiac manifestations but developed prolonged refractory asystole after 12 days of ingestion of the compound when the acute effects had subsided. We emphasize the importance of being aware of the potential for OP compounds to cause late onset asystole and the need for continued EKG monitoring even after the acute symptoms appear to have settled.

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Section: Discussionmentioning

confidence: 99%

Late Onset, Prolonged Asystole Following Organophosphate Poisoning: A Case Report

Chacko

Elangovan

2010

J. Med. Toxicol.

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“…Elevated ST segment was seen in 25.2% patients. 17 The limitation of our study is that the final outcome of patients was not observed as it was not the aim of our study.…”

Section: Discussionmentioning

confidence: 99%

Acute Organophosphate Poisoning; Electrocardiographic Manifestations

Sajid

Ghuman

Iqbal

et al. 2017

TPMJ

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Patients and methods:All patients of either sex presenting with the history or evidence of exposure to organophosphorus compounds within 24 hours with characteristics manifestations of organophosphate poisoning were included in the study. Electrocardiographic manifestations were observed before the institution of medical therapy. Results: A total of 123 patients, 81 (65.9%) male and 42 (34.1%) female were included in the study. The Mean (+SD) age of the study participants was 29.07 (+ 9.61) years. Majority (74%) patients had age <35 years and 78 (63.4%) patients in this study had time duration of <6 hours between ingestion of organophosphorus and institution of therapy. The overall electrocardiographic changes were observed in 86.2% of patients. Out of these, ST elevation was seen in 19.8%, T-wave inversion in 17.9%, prolonged PR interval in 9.4%, atrial fibrillation in 6.6% and prolonged QTc interval seen in 46.2%. Conclusion: Electrocardiographical changes are common manifestation of acute organophosphate poisoning. Prolonged QTc interval and ST segment elevation are the most common finding in our patients. As these changes in ECG can lead to serious consequences, therefore it should be carefully evaluated in every patient with OP so that early intervention can be done.

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“…279À281 Late-onset arrhythmias may represent healing myocardium or increased free fatty acid levels in the myocardium. 276,280,287 Poor prognostic factors include a combination of ST segment and T-wave changes with concomitant low-voltage complexes. 276 It is difficult to predict which patients are likely to develop the cardiac manifestations of organophosphate poisoning and when after exposure these toxicities may manifest.…”

Section: Organophosphatesmentioning

confidence: 99%