Mobitz Type II Atrioventricular Heart Block After Candlenut Ingestion

Area of Science:

• Cardiology
• Pharmacology
• Toxicology

Background:

• Candlenut is widely marketed as a natural weight-loss aid.
• The precise mechanisms of action and adverse effects of candlenut are not well-established.
• Reported adverse events include nausea, vomiting, fatigue, cardiac dysrhythmias, and mortality.

Observation:

• A 44-year-old woman presented with syncope and second-degree Mobitz type II atrioventricular block.
• Her symptoms began shortly after consuming a candlenut supplement.
• A digoxin concentration was detected, though its clinical significance was uncertain.

Findings:

• Candlenut consumption was temporally associated with the development of a significant atrioventricular block.
• The patient's cardiac rhythm normalized during hospitalization.
• The exact role of the detected digoxin level in the patient's presentation remains unclear.

Implications:

• This case underscores the potential for serious cardiac toxicity from candlenut supplements.
• Further research is warranted to elucidate the cardiotoxic mechanisms of candlenut.
• Healthcare providers should exercise caution when recommending or managing patients using candlenut for weight loss.