Patterns of cardiac dysfunction after carbon monoxide poisoning.

Area of Science:

• Cardiology
• Toxicology
• Medical Imaging

Background:

• Carbon monoxide (CO) poisoning is a prevalent health concern.
• While acute cardiac injury is recognized, long-term myocardial effects remain unclear.
• Understanding structural sequelae is crucial for survivor management.

Purpose of the Study:

• To describe the mid- and long-term structural and functional cardiac sequelae of carbon monoxide poisoning.
• To assess these effects using stress cardiac magnetic resonance (CMR) imaging.
• To identify factors associated with cardiac dysfunction post-CO exposure.

Main Methods:

• Retrospective review of 88 stress CMR studies for patients diagnosed with CO poisoning (2005-2014).
• Stratification into acute (≤12 months, 12-60 months, >60 months post-event) and chronic poisoning groups.
• Comparison of variables between normal and abnormal CMR findings.

Main Results:

• 30% of studies (26/88) showed abnormalities, including left and right ventricular systolic dysfunction and left ventricular dilatation.
• Abnormalities were generally mild and equally prevalent across all patient categories (acute and chronic, various timeframes).
• Dyspnea during follow-up was more common in patients with abnormal CMR findings.

Conclusions:

• Mild alterations in ventricular structure and function are frequent in carbon monoxide poisoning survivors.
• Myocardial scarring was rare, indicating that acute hypoxic injury alone may not explain observed abnormalities.
• Stress CMR is valuable for detecting subtle cardiac changes years after CO exposure.