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Published on: November 27, 2019
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Toxic Myocarditis Caused by Acetaminophen in a Multidrug Overdose
Maxime Gosselin1, Yann Dazé, Pascal Mireault
1From the Laboratoire de Sciences Judiciaires et de Médecine Légale, Montréal, Québec, Canada.
The American Journal of Forensic Medicine and Pathology
|August 11, 2017
Summary
Acetaminophen overdose can cause toxic myocarditis, a rare but fatal heart condition. This case highlights the importance of considering cardiac complications in acetaminophen poisoning, even with liver damage.
Area of Science:
- Toxicology
- Cardiology
- Forensic Pathology
Background:
- Acetaminophen (APAP) overdose is a frequent cause of acute liver failure.
- While hepatotoxicity is well-documented, cardiac complications are rarely reported.
Observation:
- An 18-year-old female presented with multi-substance overdose, including acetaminophen.
- Despite initial stabilization and management of liver damage, the patient developed unexplained cardiac dysfunction.
- Autopsy revealed acute toxic myocarditis attributed to acetaminophen toxicity.
Findings:
- Histologic examination confirmed acute toxic myocarditis as the cause of death.
- This represents one of the few reported cases of acetaminophen-induced toxic myocarditis.
- Cardiac arrest occurred despite the absence of myocardial infarction or cerebral edema.
Implications:
- Toxic myocarditis is a rare but critical complication of acetaminophen overdose.
- Clinicians and forensic pathologists must consider cardiac involvement in acetaminophen poisoning.
- Early recognition of toxic myocarditis may improve patient outcomes in overdose cases.
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