Cardiovascular Manifestations in Argemone Mexicana Poisoning (Epidemic Dropsy)

Abstract

Cardiovascular manifestations have been studied in 11 patients with argemone oil poisoning. Tachycardia, alterations in the heart sounds, cardiac enlargement, or electrocardiographic and ballistocardiographic changes indicated myocardial involvement in every case. The latter was suggestive of a nonspecific type of myocarditis and was considered to be of a minor nature. The prominent manifestations included dyspnea, edema, hepatic enlargement, and pulmonary congestion. The last 3 were probably due to capillary dilatation, whereas the cause of dyspnea was uncertain. These manifestations suggested the presence of cardiac failure, which, however, was considered unlikely except in 1 case.

Assessing the risk of epidemic dropsy from black salve use

“…High output cardiac failure with a wide pulse pressure, tachycardia, orthopnoea and gallop rhythm can result from the peripheral vasodilatory effects of AO. An apical systolic murmur due to functional mitral incompetence may occur (Sanghvi, Misra, & Bose, ), with flow murmurs being common due to associated anaemia and a high output state.…”

Epidemic dropsy in India

“…Clinical evidence of cardiomegaly may be found. Gallop rhythm and an apical systolic murmur due to functional mitral incompetence may be present 56. Flow murmurs at the base are common due to associated anaemia and high output state.…”

Argemone mexicana L. Papaveraceae

“…Though A. mexicana is a valuable medicinal plant, secondary metabolites from it are known to have toxic effects on animals including humans. Toxic effects on both human and animals include cardiovascular manifestations such as dyspnea, edema, hepatic enlargement, and pulmonary congestion (Sanghvi et al 1960), epidemic dropsy or genotoxic activity (Sanghvi et al 1960;Vaidya et al 1980;Dalvi 1985;Verma et al 2001;Ansari et al 2004Ansari et al , 2005Ghosh and Mukherjee 2016), stimulating heart, respiration, skeletal muscles, and blood pressure (Bose et al 1963), depression, edema and death (Norton and O'Rourke 1980;Pahwa and Chatterjee 1989), hepatotoxic (Dalvi 1985), antispermatogenic (Gupta et al 1990), testicular or fertility disorders (Mishra et al 2009), reproductive and developmental disorders (Tamboli et al 2010).…”