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Electrocardiographic Manifestations in Acute Methanol Poisoning Cannot Predict Mortality

Hossein Sanaei-Zadeh ; Emergency Room/Division of Medical Toxicology, Hazrat Ali-Asghar (p) Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammadali Emamhadi ; Department of Forensic Medicine and Toxicology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hoorvash Farajidana ; Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
Nasim Zamani ; Department of Clinical Toxicology Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abdollah Amirfarhangi ; Department of Cardiology, Hazrat Rasoul Akram (p) Hospital, Iran University of Medical Sciences, Tehran, Iran

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The aim of this retrospective observational case series was to determine electrocardiographic (ECG) manifestations in patients poisoned with methanol and see whether they could predict mortality. We also wanted to see whether there was an association between ECG changes and time elapsed between ingestion and treatment, age, sex, seizure, coma (Glasgow Coma Scale ≤8), arterial blood gas (ABG) parameters, and serum potassium levels on hospital admission. The study included 42 patients aged 31.14±12.5 years. Twenty-five survived and 17 died. Almost all patients had one or more abnormal ECG findings, including heart rate, rhythm, and conduction abnormalities. However, we found no significant difference between survivors and non-survivors. QTc interval did not correlate with time elapsed between ingestion and treatment, age, sex, seizure and coma, HCO3-, or serum potassium level. Similarly, T waves showed no correlation with serum potassium. ECG abnormalities did not correlate with coma or seizure. Even though cardiotoxicity in methanol poisoning is high, none of the ECG abnormalities found in our study predicted mortality. This however does not rule out the need to routinely run ECG for cardiotoxicity in every single patient poisoned by methanol.


death, ECG, electrocardiogram, intoxication, methanol

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