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Cardiotoxic effect due to accidental ingestion of an organic solvent
Urszula Izabela Cieślik-Guerra1, Tomasz Rechciński2, Ewa Trzos2
1Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology, Bieganski Hospital). cieursz@wp.pl.
Abstract:
Toxic myocardial injury can be misdiagnosed as a myocardial infarction, resulting in the patient undergoing standard treatment for cardiac rehabilitation. However, such inadequate therapeutic strategies can lead to cardiovascular complications including dilated cardiomyopathy. This study presents a case of a 65-year-old man after accidental ingestion of organic solvents (toluene and xylene), whose condition demonstrated all the criteria for diagnosis of myocardial infarction. The qualitative determinations of the above mentioned volatile organic compounds (VOCs) in whole blood were carried out using a headspace sampling by means of gas chromatography. Cardiac catheterization revealed no specific coronary lesions, only a muscular bridge causing a 30-50% stenosis in the middle of the circumflex branch of the left coronary artery.
Insights
Accidental ingestion of organic solvents mimicked myocardial infarction, leading to potential misdiagnosis. Early identification of toxic myocardial injury is crucial to prevent cardiac complications like dilated cardiomyopathy.
Area of Science:
- Toxicology
- Cardiology
- Analytical Chemistry
Background:
- Toxic myocardial injury can be misdiagnosed as myocardial infarction.
- Inadequate treatment can lead to severe cardiovascular complications such as dilated cardiomyopathy.
Observation:
- A 65-year-old man presented with symptoms fulfilling myocardial infarction criteria after accidental ingestion of toluene and xylene.
- Gas chromatography identified volatile organic compounds (VOCs) in whole blood.
Findings:
- Cardiac catheterization showed no significant coronary artery disease, only a muscular bridge.
- The patient's condition mimicked myocardial infarction due to toxic myocardial injury from solvent ingestion.
Implications:
- Highlights the importance of considering toxicological causes in myocardial injury diagnoses.
- Emphasizes the need for specific diagnostic approaches beyond standard cardiac workups for solvent-induced cardiac injury.
- Underscores the potential for misdiagnosis and delayed appropriate treatment in toxic myocardial injury cases.
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