Sudden Death Caused by 1,1-difluoroethane Inhalation

Xiong, Zhenggang; Avella, Joseph; Wetli, Charles V.

doi:10.1520/jfs2003250

Cited by 32 publications

(15 citation statements)

References 12 publications

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“…Evidence suggests that inhalants such as fluorocarbons ''sensitize'' the heart so that ventricular fibrillation can be triggered by events that would normally be harmless [3,4,12,13]. Fortunately, our patient did not suffer a fatal arrhythmia.…”

Section: Discussionmentioning

confidence: 70%

Huffing-Induced Cardiomyopathy: A Case Report

Samson¹,

Kado²,

Chapman³

2011

Cardiovasc Toxicol

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The intentional inhalation of fumes from gasoline or solvents for recreational purposes is commonly known as Huffing, Sniffing or Dusting (Anderson and Loomis in Am Fam Physician 68(5):869-874, 2003). Inhalant abuse is known to be "Cardio-toxic", causing sudden death and chronic myocardial damage (Meadows and Verghese in South Med J 89(5):455-462, 1996; Anderson and Loomis in Am Fam Physician 68(5):869-874, 2003). We report a 20-year-old white man who presented with altered mental status following ingestion of multiple alprazolam and oxycodone tablets. He was found to have diffused ST-T changes on his EKG. Cardiac enzymes were found to be elevated-CK: 599 U/L, CK-MB: 16.8 ng/mL and Troponin: 0.78 ng/mL. A transthoracic echocardiogram (TTE) revealed global left ventricular (LV) dysfunction with an ejection fraction (EF) of 10-15%. During hospitalization, the cardiac enzymes started trending downward and this was followed by spontaneous resolution of the LV dysfunction. The patient also admitted to inhaling "Dust-Off" spray 2-3 days prior to admission. Inhalant abuse can cause cardiomyopathy and should be considered a probable cause in patients presenting with cardiac dysfunction of unknown etiology, particularly in teenagers and young adults.

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Section: Discussionmentioning

confidence: 70%

Huffing-Induced Cardiomyopathy: A Case Report

Samson¹,

Kado²,

Chapman³

2011

Cardiovasc Toxicol

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“…The compression marks of the gas mask were left clearly on his face; it was supposed that the mask fi tted tightly. Because of such circumstances, we fi rstly suspected that the cause of his death was suffocation, but the concentrations of DFE in most of the samples were much higher than those in fatal cases reported previously [1,2]. Xiong et al [1] and Avella et al [2], in reports of fatal cases of DFE inhalation, described DFE concentrations in blood of 123 and (Table 1).…”

Section: Cause Of Deathmentioning

confidence: 91%

“…Table 1 indicates the concentrations of DFE detected in various autopsy samples in this case. The concentrations of DFE obtained from other fatal cases of DFE inhalation reported previously [1,2] are also indicated. The concentrations of DFE in the present case were much higher than those in fatal cases reported previously.…”

Section: Sample Collectionmentioning

confidence: 99%

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A fatality due to inhalation of 1,1-difluoroethane (HFC-152a) with a peculiar device

et al. 2009

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“…5,9 Myocardial degenerative changes like interfibrillary edema, swollen and ruptured fibrils, congestive heart failure from chronic myocarditis, and fibrosis have been seen in chronic inhalant-abusers. 5,9 The most common cause of "sudden sniffing death" is cardiac arrhythmia, usually associated with the use of toluene and 1,1,1-trichloroethane.…”

Section: Cardiac Manifestationsmentioning

confidence: 99%

Inhalant-Abuse Myocarditis Diagnosed by Cardiac Magnetic Resonance

Dinsfriend¹,

Rao²,

Matulevicius³

2016

Texas Heart Institute Journal

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Myocarditis is an inflammatory disease of the cardiac muscle that can be caused by infections, autoimmune disorders, hypersensitivity reactions, and cardiotoxins.1 Although the exact prevalence of myocarditis is unknown, various studies of sudden death in adults younger than 40 years of age, athletes, and U.S. Air Force recruits found that 20% had died of myocarditis.1 Cardiotoxins causing myocarditis include catecholamines, cyclophosphamide, antipsychotic agents, cocaine, alcohol, and hydrocarbons. Hydrocarbons are propellants or refrigerants common in many household products and have been shown in multiple case reports to cause myocarditis, heart failure, and sudden death.2-5 Hydrocarbon exposure is typically from the intentional inhalation of fumes, known as huffing, sniffing, or dusting. 2 We present an illustrative case and discuss the detection of toxic myocarditis by means of cardiac magnetic resonance (CMR) imaging with delayed enhancement. Case ReportIn December 2013, a 23-year-old man presented at our hospital's emergency department with a one-day history of palpitations and substernal chest pressure associated with dyspnea and diaphoresis. His chest pressure improved in the upright position and was not associated with exertion. His medical history was significant for substance abuse, bipolar disorder, and pseudo-seizures. The patient's last admitted use of cocaine was 2 years before admission, and he reported no current recreational drug use. Upon admission, the patient had a temperature of 97.9 °F, a heart rate of 76 beats/min, a blood pressure of 144/74 mmHg, and an oxygen saturation level of 97% on room air. The patient's examination was notable for his appearance as a large, athletic, and apparently healthy white male, with dilated pupils that were equally round and reactive to light. A cardiopulmonary examination revealed clear lung sounds and no chest-wall tenderness, murmurs, rubs, or gallops.His electrocardiogram (ECG) showed sinus rhythm at a rate of 79 beats/min and incomplete right bundle branch block, with no ST-segment or T-wave abnormalities. His complete blood count, basic metabolic panel, liver function tests, D-dimer level, and urine toxicology screen (notably negative for cocaine) revealed nothing of concern, but his cardiac enzyme levels, save for normal total creatinine kinase (CK), were abnormal: a peak CK-MB fraction (CK-MB) of 6.5 µg/L and a peak troponin T level of 0.13 µg/L.

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Sudden Death Caused by 1,1-difluoroethane Inhalation

Cited by 32 publications

References 12 publications

Huffing-Induced Cardiomyopathy: A Case Report

Huffing-Induced Cardiomyopathy: A Case Report

A fatality due to inhalation of 1,1-difluoroethane (HFC-152a) with a peculiar device

Inhalant-Abuse Myocarditis Diagnosed by Cardiac Magnetic Resonance

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