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Blue dye, green heart.

Carmela D Tan1, E Rene Rodriguez

  • 1Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue/L25, Cleveland, OH 44195, USA. tanc@ccf.org

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|August 16, 2008
PubMed
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Methylene blue, used for septic shock, caused a green discoloration of the heart muscle observed during autopsies. This color change is due to the oxidation of a methylene blue metabolite in the presence of oxygen.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Pathology

Background:

  • Methylene blue is a treatment for refractory circulatory shock.
  • Septic shock is a life-threatening condition requiring advanced interventions.
  • Clinical side effects of methylene blue are documented.

Purpose of the Study:

  • To report an autopsy observation in patients treated with methylene blue for septic shock.
  • To investigate the visual changes in cardiac tissue after methylene blue administration.

Main Methods:

  • Autopsy examination of patients who received methylene blue as adjunct therapy for septic shock.
  • Observation of fresh and fixed cardiac myocardium.
  • Analysis of the chemical properties of methylene blue metabolites.

Related Experiment Videos

Main Results:

  • Cardiac myocardium exposed to methylene blue rapidly turned green.
  • This color change was observed in both fresh and fixed tissue samples.
  • The green color is attributed to the oxidation of leukomethylene blue to methylene blue in the presence of oxygen.

Conclusions:

  • Methylene blue administration can lead to a visible green discoloration of cardiac myocardium.
  • This phenomenon is explained by the redox chemistry of methylene blue and its metabolites.
  • The observation provides insight into the tissue distribution and metabolic fate of methylene blue.