Short communication, Note
https://doi.org/10.2478/aiht-2021-72-3502
Unusual aetiology of a type 2 myocardial infarction: a case-based review
David Toma
orcid.org/0000-0002-2054-3841
; Sf. Spiridon Emergency County Hospital, Emergency Department, Iași, Romania
Tania-Emima Toma
orcid.org/0000-0002-1492-3776
; Sf. Maria Emergency Children’s Hospital, General Paediatrics, Iași, Romania
Cristina Bologa
; “Grigore T. Popa” University of Medicine and Pharmacy, School of Medicine, Internal Medicine and Clinical Toxicology Department, Iași, Romania 4 Sf. Spiridon Emergency County Hospital, 2nd Internal Medicine Clinic, Iași, Romania
Cătălina Lionte
orcid.org/0000-0002-0525-0645
; “Grigore T. Popa” University of Medicine and Pharmacy, School of Medicine, Internal Medicine and Clinical Toxicology Department, Iași, Romania 4 Sf. Spiridon Emergency County Hospital, 2nd Internal Medicine Clinic, Iași, Romania
Abstract
Organophosphate pesticide (OP) poisoning is quite common and can cause cardiovascular complications and even direct myocardial injury. However, no guideline has included an acute poisoning as a potential cause for a type 2 myocardial infarction (MI) so far. Here we present a case of a 61-year-old woman brought by ambulance to emergency department one hour after accidental ingestion of an unknown quantity of a solution she used against flea infestation. The patient presented with dizziness, myosis, excessive sweating, hypersalivation, sphincteric incontinence, muscle fasciculation, tremor of the extremities, pale skin, alcoholic and pesticide breath odour. Even though we had no guidelines to fall back on, we successfully treated the patient with low-molecular-weight heparin, antiplatelets, statin, diltiazem, antidote therapy, and supportive care. Physicians should be aware that OP poisoning can induce type 2 MI as a complication within a few hours since exposure, and emergency management should always include close cardiac monitoring.
Keywords
cardiovascular events; organophosphate poisoning; toxicology
Hrčak ID:
253772
URI
Publication date:
16.3.2021.
Visits: 1.063 *