[Evaluation of carbon monoxide cardiotoxicity in group poisonings]

The aim of the study was to estimate the usefulness of rest 99mTc-MIBI SPECT scintigraphy to evaluate carbon monoxide cardiotoxicity in acute group poisonings. There were 7 study patients (5 men and 2 women) aged from 14 to 35 years treated at the Department of Clinical Toxicology intoxicated with CO at three different sites: three persons were intoxicated at one, two persons at the second and the next two persons at another site of exposure. As derived from interview the circumstances, source and duration of exposure were similar within the separate group. This enables a comparison of clinical course of carbon monoxide poisoning, particularly the circulatory system of people who were simultaneously exposed to the same source of carbon monoxide. Measurement of COHb, blood lactate level, duration of exposure and ECG examination were performed on admission to the Clinic. The enzymes activity (ALT, AST, CPK) were evaluated after 24 hours. The rest 99mTc-MIBI SPECT scintigraphy was performed in all patients two to five days after intoxication. The changes in myocardial scans were graded according to the arbitrarily accepted point scale. Considering the results of ECG and enzymes activity only, no objective were found to diagnose the cardiac dysfunction. However the perfusion scintigraphy scans indicated regions of myocardium that have decreased blood flow in all the study patients.