Cardiac abnormalities in severe acute dichlorvos poisoning
Xinhua He1, Chunsheng Li, Dongmei Wei
1Department of Emergency, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Critical Care Medicine
|April 26, 2011
Summary
Organophosphorus poisoning can cause heart damage. This study found that severe dichlorvos poisoning leads to temporary myocardial dysfunction, likely due to increased catecholamine levels, which is reversible.
Area of Science:
- Toxicology
- Cardiology
- Emergency Medicine
Background:
- Organophosphorus poisoning is a significant public health concern.
- Sudden cardiac events and myocardial injury are potential complications in severe poisoning cases.
- Understanding the mechanisms of cardiotoxicity is crucial for effective treatment.
Purpose of the Study:
- To investigate the mechanisms of cardiotoxicity induced by severe acute dichlorvos poisoning.
- To elucidate the association between organophosphorus poisoning and myocardial injury.
- To assess the reversibility of cardiac dysfunction following dichlorvos exposure.
Main Methods:
- Prospective observational study involving 41 patients with severe acute dichlorvos poisoning.
- Serial measurements of cardiac biomarkers (creatine kinase isoenzyme myocardium, cardiac troponin I), neurotransmitters (acetylcholine, epinephrine, norepinephrine), and acetylcholinesterase.
- Electrocardiography, transthoracic echocardiography, and technetium 99m-sestamibi myocardial single photon emission computed tomography were performed.
Main Results:
- 90.2% of patients survived; 9.8% died during treatment.
- Sinus tachycardia (90.2%) and ST-T changes (80.4%) were common.
- Cardiac biomarkers and catecholamine levels peaked early and subsequently decreased.
- Echocardiography showed reversible decreases in left ventricular function and wall motion.
- Left ventricular ejection fraction significantly improved from 42% to 59% (p = .001).
Conclusions:
- Severe acute dichlorvos poisoning is linked to reversible myocardial dysfunction.
- Elevated catecholamine levels may play a role in the cardiotoxicity observed.
- Prompt diagnosis and management can lead to recovery of cardiac function.
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