Herb-induced cardiotoxicity from accidental aconitine overdose

Bradycardia and Hypotension from Improper Use of Aconite Root: A Case Report and Brief Review

“…It is not practical to diagnose aconite poisoning with an assay detecting concentrations of diverse Aconitum alkaloids in blood or urine samples [12]. Because there is no specific antidote, supportive care based on blood pressure and cardiac rhythm can prevent refractory ventricular arrhythmias or asystole, which are the main causes of death during the first 24 h [18,22,25]. Understanding the interactions with electrolyte channels and cellular mechanisms relevant to the toxicology of Aconitum can contribute to the appropriate application of agents for aconite-related cardiotoxicity [25].…”

“…1). Based on these preliminary data, the possible differential diagnoses were age-related sick sinus syndrome, coronary artery disease compromising the arteries supplying the sinoatrial node, endocrine diseases associated with declining general cardiac activity, such as hypothyroidism or adrenal insufficiency, medication-related side effects, or long QT syndrome [20,21,22]. She was immediately administered an intravenous (IV) infusion of 0.9% of normal saline (80 ml/h), 2 ampules dopamine (200 mg/5 ml/ampule, with an IV drip at 10 ml/h, 5.3 μg/kg/min), atropine 0.5 ampule (1 mg/1 ml/ampule, as an IV bolus), and oxygen inhalation (10 l/min).…”

“…Her arterial blood gas parameters, thyroid function tests, and serum electrolytes were all within normal limits. The digoxin level was below 0.3 ng/ml [22]. The most probable etiology was therefore a side-effect of the improper use of the CHM containing Fuzi.…”

Accidental poisoning with Aconitum: Case report and review of the literature

“…The genus Aconitum (Ranunculaceae) consists of hundreds of plant species containing alkaloids, such as aconitine, which have been related to cardiotoxicity, neurotoxicity, and gastrointestinal toxicity . First described by Fleming in 1845, Aconitum grows in Europe, North America, and Asia and its roots are mainly used in traditional Chinese medicine (TCM) for topical applications to treat musculoskeletal chronic pain . By now, hundreds of TCM formulations, comprising Aconitum, have been described in historical literature and modern clinical reports.…”

“…1 First described by Fleming in 1845, 2 Aconitum grows in Europe, North America, and Asia and its roots are mainly used in traditional Chinese medicine (TCM) for topical applications to treat musculoskeletal chronic pain. 3 By now, hundreds of TCM formulations, comprising Aconitum, have been described in historical literature and modern clinical reports. Poisoning can be caused by incorrect preparation and application or ingestion of herbal infusions containing Aconitum roots derivatives.…”