Cardiogenic Shock Related to Carbon Monoxide Poisoning

Abstract

Carbon monoxide (CO) poisoning is one of the leading causes of death by poisoning in occidental countries. We report the presentation and management of a patient who developed a severe cardiac dysfunction, leading to profound cardiogenic shock after CO poisoning despite an initial low CO blood level.

Mass Carbon Monoxide Poisoning in a Family: A Case Report from Nepalgunj

“…7 Carbon monoxide poisoning has been associated with amnesia, encephalopathy, dysarthria, parkinsonism, peripheral neuropathy, bullous skin lesions, supranuclear gaze palsy, cerebral haemorrhage, cardiotoxicity and muscle necrosis with renal failure. 8 CO binds to myocardial myoglobin more slowly than it does to hemoglobin, but the bond is stronger and the release slower. 7 CO-related cardiovascular dysfunction includes angina, myocardial infarction, arrhythmia, left ventricular dysfunction, transient myocardial stunning, cardiogenic shock, and sudden death.…”

“…7 CO-related cardiovascular dysfunction includes angina, myocardial infarction, arrhythmia, left ventricular dysfunction, transient myocardial stunning, cardiogenic shock, and sudden death. 8 This patient developed pulmonary edema which was evident by cherry red frothy secretions during intubation, basal crepts in bilateral lungs ans acute respiratory distress with saturation dropping to 25% in room air. The possible causes of pulmonary edema include toxic effects of CO on the alveolar membranes, myocardial damage leading to left ventricular failure, the aspiration of gastric contents after loss of consciousness, and neurogenic pulmonary edema.…”