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Effects of Acute Carbon Monoxide Poisoning on ECG and Echocardiographic Parameters in Children

Abdullah Ozyurt1, Derya Karpuz2, Aydin Yucel3

  • 1Department of Pediatric Cardiology, Ministry of Health, Mersin Woman's and Children's Hospital, 33240, Toroslar-Mersin, Turkey. duruozyurt@yahoo.com.tr.

Cardiovascular Toxicology
|October 26, 2016
PubMed

Insights

Carbon monoxide (CO) poisoning in children significantly impacts the heart, causing impaired ventricular repolarization and subclinical left ventricle dysfunction. These cardiovascular effects appear reversible in pediatric CO poisoning cases.

Area of Science:

  • Pediatric Cardiology
  • Toxicology
  • Cardiovascular Physiology

Background:

  • Carbon monoxide (CO) poisoning is a significant concern in pediatrics.
  • The cardiovascular system is particularly vulnerable to CO toxicity.
  • Subclinical cardiac dysfunction may occur even in mild pediatric CO poisoning cases.

Purpose of the Study:

  • To investigate the cardiovascular effects of CO poisoning in children.
  • To evaluate electrocardiographic, echocardiographic, and biochemical changes in pediatric CO poisoning.
  • To assess the reversibility of cardiac dysfunction following CO exposure.

Main Methods:

  • Prospective study comparing 22 children with CO poisoning to 24 healthy controls.
  • Electrocardiography and echocardiography performed daily post-admission.
  • Biochemical markers including troponin I and creatinine kinase-MB (CK-MB) assessed daily.

Main Results:

  • CO-intoxicated children showed significantly prolonged Tpeak-end, QTc durations, Tpeak-end dispersion, and Tpeak-end/QT ratio.
  • Echocardiography revealed significantly lower mitral E duration, mitral E/A ratio, and left ventricle contractile fraction, with a higher myocardial performance index.
  • Elevated troponin I and CK-MB levels were observed in 27% and 18% of CO-poisoned children, respectively.

Conclusions:

  • The heart is a critical target organ in pediatric CO poisoning.
  • Children with CO poisoning exhibit subclinical systolic and diastolic left ventricle dysfunction.
  • Ventricular repolarization abnormalities in pediatric CO intoxication are likely reversible.

Keywords:
Carbon monoxideCardiac biomarkersCardiomyopathyDysrhythmiaEchocardiographyElectrocardiographyPoisoningVentricular repolarization

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