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Electrocardiographic Findings in Mortalities Due to Pure Methadone Toxicity

Mehdi Sheibani1, Nasim Zamani2, Hossein Hassanian-Moghaddam3,4

  • 1Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.

Cardiovascular Toxicology
|July 19, 2018
PubMed

Insights

Electrocardiogram (ECG) abnormalities are common in deaths from methadone toxicity, suggesting cardiac involvement. These ECG changes, unrelated to coronary artery disease, highlight potential myocardial effects contributing to mortality.

Area of Science:

  • Cardiology
  • Toxicology
  • Intensive Care Medicine

Background:

  • Methadone toxicity can lead to mortality, potentially due to cardiac complications.
  • Electrocardiographic (ECG) changes may indicate cardiac involvement in acute methadone toxicity.
  • Understanding these ECG abnormalities is crucial for managing methadone poisoning.

Purpose of the Study:

  • To evaluate electrocardiographic (ECG) abnormalities in patients who died from pure methadone toxicity.
  • To determine if cardiac complications, identified via ECG, contribute to methadone-related mortality.
  • To investigate differences in ECG findings between methadone-dependent and methadone-naïve patients.

Main Methods:

  • Retrospective single-center study of patients deceased from pure methadone toxicity (2011-2016).
  • Evaluation of patient files, including autopsy reports.
  • Cardiologist assessment of all quantitative and qualitative ECG indices.

Main Results:

  • All 51 deceased patients exhibited ECG abnormalities.
  • ST-T abnormalities were present in 64.7% of cases.
  • Longer PR intervals were noted in dependent patients, while naïve cases showed specific ST elevation; other ECG indices were similar.

Conclusions:

  • ECG abnormalities are prevalent in methadone toxicity mortalities and are not correlated with coronary artery disease.
  • Methadone toxicity may directly affect the myocardium, contributing to death.
  • Further prospective studies are recommended to explore cardiac indices in methadone-poisoned patients.
Keywords:
Coronary artery diseaseElectrocardiographyMethadonePoisoning

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