Severe Oleander Poisoning Presenting with Hyperkalaemia and Unusual Electrocardiographic Changes
Satyabrata Guru1, Anupama Behera1, Sadananda Barik1
1All India Insititute of Medica Sciences, Bhubaneswar, Odisha, India.
Background:
Hyperkalaemia in oleander (Nerium oleander) poisoning has been associated with a poor prognosis. Different electrocardiographic (ECG) presentations are possible because of vagotonia and hyperkalaemia.
Methods/Results:
We report a series of three cases of oleander poisoning in which ECG showed unusual hyperkalaemia features, such as bradyarrhythmia, sinoatrial block, atrioventricular block and junctional rhythm.
Conclusions:
If arterial blood gas analysis or laboratory values indicate hyperkalaemia in oleander poisoning, the hyperkalaemia should be treated immediately, even if the ECG does not show typical hyperkalaemia features.
Learning Points:
Hyperkalaemia in oleander poisoning is associated with a poor prognosis.Hyperkalaemia should be treated aggressively in oleander poisoning even if the ECG does not show typical features, as mimics other conditions on ECG.
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