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Published on: April 18, 2013
[Heart injury secondary to carbon monoxide poisoning--the use of imaging techniques]
Małgorzata Kołodziej1, Kamil Zaleski1, Magdalena Majewska2
1Wojewódzki Szpital Specjalistyczny im. Stefana Kardynała Wyszyńskiego, Samodzielny Publiczny Zakład Opieki, Zdrowotnej w Lublinie, Oddział Toksykologiczno-Kardiologiczny.
Insights
Carbon monoxide poisoning frequently causes heart muscle damage. Echocardiography is recommended for diagnosing cardiac injury in poisoned patients, especially when initial tests show abnormalities.
Area of Science:
- Cardiology
- Toxicology
- Medical Imaging
Context:
- Carbon monoxide (CO) poisoning significantly impacts cardiac health, affecting 30-40% of patients.
- Current diagnostic standards for CO-induced cardiac injury rely on ECG and cardiac markers like troponin I.
- There's a lack of established guidelines for further cardiac assessment following initial diagnostic abnormalities.
Purpose:
- To review cardiac imaging modalities for diagnosing myocardial injury in carbon monoxide poisoning.
- To analyze the utility of various imaging techniques in the context of CO toxicity.
- To establish recommendations for diagnostic imaging in CO-poisoned individuals.
Summary:
- The heart muscle's vulnerability to carbon monoxide necessitates thorough cardiac evaluation.
- Echocardiography emerges as a crucial, non-invasive tool for assessing myocardial injury.
- This review highlights echocardiography's role in conjunction with ECG and cardiac biomarkers for comprehensive diagnosis.
Impact:
- Echocardiography should be routinely considered for patients with suspected CO-induced myocardial injury.
- Implementing echocardiography can improve the diagnostic accuracy and management of cardiac complications in CO poisoning.
- This approach aids in timely identification and treatment of cardiovascular issues in affected patients.
Abstract:
The heart muscle is particularly sensitive to the toxic effects of carbon monoxide. Cardiovascular complications are present in 30-40% poisoned patients. Currently, multiple ECG records and at least two-time determination of cardiac markers' concentration (mainly troponin I) are known as the gold standard practice in the diagnosis of cardiac injury especially with regard to medium and severe poisoning. So far there have not been any recommendations for further diagnostic steps in case of abnormalities in these examinations. This paper presents a review of cardiac imaging techniques as well as the analysis of their usefulness in carbon monoxide poisoning. According to the authors echocardiography is considered to be an extremely important examination which, thanks to its accessibility and non-invasive nature, should be performed on all patients with myocardium injury suspicion made on the basis of clinical image, ECG records and biochemical markers.
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