Acute myocardial infarction

Joshi, Prakash; Manoria, Piyush; Joseph, Diane; Gandhi, Zainab

doi:10.4103/0022-3859.113843

Cited by 14 publications

(10 citation statements)

References 7 publications

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“…[27][28][29] The bradycardia in the early cholinergic phase of the poisoning was less frequently observed whereas the hypertension and sinus tachycardia seen in organophosphate and carbamate poisoning due to nicotinic effects was found in our study. Administration of atropine in high doses has been implicated in the development of ventricular arrhythmias.…”

Section: Discussionmentioning

confidence: 51%

Study of clinical profile of organophosphorus poisoning with special reference to electrocardiographic changes and electrolyte derangement

et al. 2018

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Background: Organophosphorus Compounds (OPC) are main cause of accidental and suicidal poisoning in agrarian countries like India. Aim was to study the clinical profile of OPC-Poisoning and correlate it with the electrocardiographic (ECG) changes and electrolyte abnormalities.Methods: Hundred consecutive cases admitted to Medicine Department underwent clinical examination, ECG, electrolytes, Acetyl Choline Esterase (AChE) estimation from time to time and Paradeniya Organophosphorus Poisoning (POP) score at the time of admission. All these parameter with duration of hospital stay and outcome were statistically analysed using X2 test, Fisher exact test, and inference was drawn.Results: In hundred OPC-Poisoning patients [Male (n=48), Female (n=52), M: F ratio 0.92:1] with mean age of 37.78±12.95 years, commonest poison was cholropyrifos+cypermethrin and was mostly suicidal (96%). Common symptoms were sweating (48%), salivation, blurring of vision, breathlessness and signs were smell of poison (90%), tachypnea, altered sensorium, miosis and fasciculation. POP scoring found 41% of patients in mild, 26% in moderate and 33% in sever grade of poisoning. Hospital stay ranged from 4-18 days. Complications were pulmonary Edema (PE) in 28%, Respiratory Failure (RF) 18%, Aspiration Pneumonia (AP) 15% and Intermediate Syndrome (IS) 4%. 10 died out of 42 patients who had complications and the cause of death was RF in 4, Ventricular Fibrillation (VF) 2 and IS in 2. ECG finding showed sinus tachycardia (31%), prolonged corrected QT (QTc) interval (28%), sinus bradycardia (25%), ST-T changes (17%) and Premature Ventricular Contraction (PVC) in 4% which degenerated to VF in 2%. 24 patients were Hypokalemic from which 16 developed complications.Conclusions: Similar to earlier studies we observed poisoning which was suicidal. QTc prolongation and Hypokalemia are associated with high morbidity and mortality in OPC-Poisoning.

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Section: Discussionmentioning

confidence: 51%

Study of clinical profile of organophosphorus poisoning with special reference to electrocardiographic changes and electrolyte derangement

et al. 2018

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“…Different individual toxicokinetics of OPCs necessitates investigating the effect on the heart under normal and diabetic conditions (22). The cardiovascular manifestation of OPC poisoning is mainly attributed to acute poisoning (23)(24)(25)(26)(27), which comprises bradycardia or tachycardia or impaired heart rate. There are reports showing an increased level of creatine kinases and lactate dehydrogenases, besides myocardial necrosis (28).…”

Section: Discussionmentioning

confidence: 99%

Terbufos-sulfone exacerbates cardiac lesions in diabetic rats: a sub-acute toxicity study

Nurulain

Shafiullah

Yasin

et al. 2016

Archives of Industrial Hygiene and Toxicology

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Organophosphorus compounds (OPCs) have a wide range of applications, from agriculture to warfare. Exposure to these brings forward a varied kind of health issues globally. Terbufos is one of the leading OPCs used worldwide. The present study investigates the cardiac effect of no observable dose of a metabolite of terbufos, terbufos-sulfone (TS), under nondiabetic and streptozotocin-induced diabetic condition. One hundred nanomoles per rat (1/20 of LD 50 ) was administered intraperitoneally to adult male Wister rats daily for fifteen days. The left ventricle was collected for ultrastructural changes by transmission electron microscopy. The blood samples were collected for biochemical tests including RBC acetylcholinesterase, creatinine kinase (CK), lactate dehydrogenase (LDH), cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, ALT, AST, and GGT. The study revealed about 10 % inhibition of RBCAChE in two weeks of TS treatment in non-diabetic rats whereas RBC-AChE activity was significantly decreased in diabetic TS treated rats. CK, LDH, and triglycerides were significantly higher in diabetic TS treated rats. Electron microscopy of the heart showed derangement and lesions of the mitochondria of cardiomyocytes in the TS treated groups. The present study concludes that a non-lethal dose of TS causes cardiac lesions which exacerbate under diabetic condition. Biochemical tests confirmed the ultrastructural changes. It is concluded that a non-lethal dose of TS may be a risk factor for a cardiovascular disease, which may be fatal under diabetic condition.

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“…Joshi et al [13] reported a case of OP followed by acute myocardial infarction, which they attributed to cardiac complications of OP. In our case, although we could not exclude myocardial infarction as a diagnosis or OP resulting in mortality, the cause of OHCA was surely cardiac complications as a result of OP.…”

Section: Discussionmentioning

confidence: 99%

Organophosphate poisoning presenting as out-of-hospital cardiac arrest: A clinical challenge

Kuo

Yen

et al. 2017

Journal of Cardiology Cases

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A B S T R A C TOut-of-hospital cardiac arrest (OHCA) remains a challenge for physicians since effective management and definitive salvage depend upon correct determination of the etiology and the extent of injury. Definitive diagnosis of organophosphate poisoning (OP) requires physicians' clinical awareness of a typical toxidrome, that is, characteristic signs and symptoms of poisoning, and laboratory confirmation.Here we report a case of an OHCA patient with OP, which was initially misdiagnosed as an acute ST segment elevation myocardial infarction based on the patient's medical history and clinical manifestations.

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Acute myocardial infarction

Cited by 14 publications

References 7 publications

Study of clinical profile of organophosphorus poisoning with special reference to electrocardiographic changes and electrolyte derangement

Study of clinical profile of organophosphorus poisoning with special reference to electrocardiographic changes and electrolyte derangement

Terbufos-sulfone exacerbates cardiac lesions in diabetic rats: a sub-acute toxicity study

Organophosphate poisoning presenting as out-of-hospital cardiac arrest: A clinical challenge

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