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A study on paracetamol cardiotoxicity.

Udaya Ralapanawa¹, Kushalee Poornima Jayawickreme², Ekanayake Mudiyanselage Madhushanka Ekanayake²

¹Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. udayapralapanawa@yahoo.com.

BMC Pharmacology & Toxicology

|July 15, 2016

Summary

This study investigated paracetamol poisoning's cardiotoxic effects in Sri Lanka. Researchers found no evidence of electrocardiographic, echocardiographic, or cardiac biomarker changes, suggesting paracetamol may not be directly cardiotoxic.

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Area of Science:

Toxicology
Cardiology
Clinical Medicine

Background:

Sri Lanka faces a high suicide rate, with paracetamol overdose being a common cause of poisoning admissions.
While paracetamol's hepatotoxicity is well-documented, its cardiotoxic effects remain minimally studied and potentially overlooked.
Previous reports suggest a possible direct cardiotoxic effect of paracetamol overdose, with some cases showing unexplained deaths and ECG changes.

Purpose of the Study:

To comprehensively assess the cardiotoxic effects of paracetamol poisoning.
To investigate potential direct cardiac damage or indirect effects via metabolic derangement.

Main Methods:

A cross-sectional descriptive study was conducted on patients with confirmed paracetamol poisoning.
Key investigations included serum paracetamol levels, Electrocardiogram (ECG), Echocardiogram, troponin I, and other standard laboratory tests.

Main Results:

Paracetamol poisoning is prevalent among young populations in Sri Lanka.
This study found no significant electrocardiographic, echocardiographic, or cardiac biomarker evidence of myocardial toxicity following paracetamol poisoning.
Despite some literature suggesting cardiotoxicity, this research did not substantiate these claims.

Conclusions:

The study did not find sufficient evidence to support direct cardiotoxicity from paracetamol poisoning.
Continuous cardiac monitoring, serial troponin, and echocardiogram assessments are recommended for managing paracetamol poisoning.
Further research with larger sample sizes is warranted to fully elucidate the relationship between paracetamol poisoning and cardiac effects.