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Does organophosphate poisoning cause cardiac injury?
Abbas Aghabiklooei1, Babak Mostafazadeh, Esmaeil Farzaneh
1Department of Forensic Medicine and Toxicology, Tehran University of Medical Sciences, Tehran, Iran.
Abstract:
Organophosphates are insecticides which are widely used as a suicidal agent in Iran. They are associated with different types of cardiac complications including cardiac arrest and arrhythmia, however their role in cardiac injury is not known yet. The aim of this study was to investigate the presence of myocardial damage in patients with cholinesterase poisoning.It was a prospective study conducted from January 2008 to March 2010. Cohorts of patients with cholinesterase poisoning due to suicidal attempt who have been referred to Loghman hospital were selected. Patients who have taken more than one poison or were used concomitant drugs were excluded. Physical examination was performed on admission to discover warning sign. Peripheral arterial blood gases, creatine kinase, creatine kinase-myocardial band, troponin-T measurements were performed in all cases. There were 24 patients, 7 of them women, with the mean age of 41.2±15.05 who were included in this study. Non-survivors had significantly higher levels of systolic blood pressure, partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide, bicarbonate Glasgow Coma Scale scoring and longer duration of mechanical ventilation. Our findings showed that cardiac injury is an important cause of death in organophosphate poisoning. It could be hypothesized that cardiac injury is a strong predictor of death in patients with organophosphate poisoning.
Insights
Organophosphate poisoning can cause cardiac injury, a significant factor in patient mortality. This study highlights cardiac damage as a key predictor of death in organophosphate poisoning cases.
Area of Science:
- Toxicology
- Cardiology
- Emergency Medicine
Background:
- Organophosphates are common suicidal agents in Iran, linked to cardiac issues like arrest and arrhythmia.
- The specific role of organophosphates in causing direct cardiac injury remains unclear.
Purpose of the Study:
- To investigate myocardial damage in patients suffering from cholinesterase poisoning due to organophosphate ingestion.
- To determine if cardiac injury is a predictor of mortality in organophosphate poisoning.
Main Methods:
- Prospective study of 24 patients with organophosphate poisoning from suicidal attempts (Jan 2008-Mar 2010).
- Exclusion of patients with poly-poisoning or concomitant drug use.
- Assessment included physical examination, arterial blood gases, creatine kinase, creatine kinase-myocardial band, and troponin-T levels.
Main Results:
- Non-survivors exhibited significantly higher systolic blood pressure, partial pressure of oxygen and carbon dioxide, bicarbonate levels, and Glasgow Coma Scale scores.
- Non-survivors also required longer mechanical ventilation.
- Cardiac injury was identified as a critical factor contributing to death in organophosphate poisoning.
Conclusions:
- Cardiac injury is a significant cause of mortality in organophosphate poisoning.
- Cardiac injury may serve as a strong predictor of death in these patients.
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