[Lesion of the heart in exotoxic shock]

The functional condition of the heart in exotoxic shock, the most severe complication in the early toxicogenic form of acute poisoning, was studied in 230 patients in whom shock had developed on the background of severe acute poisoning with fluid caustics, dichloroethane, organophosphoric insecticides or soporifics. The results of the studies show that in the phase of compensated shock the revealed disorders are mainly due to the compensatory intensification of the cardiac activity in response to the "chemical trauma". Affection of the contractile myocardium in this period of shock does not play any noticeable role in the development of hemodynamic disorders, the only exception are cases in which the preparation that had caused the poisoning possesses a specific cardiotoxic effect ("primary specific cardiotoxic effect"). The increase of the general phenomena of disorders of microcirculation and hypoxia leads to diminution of the enzyme control of metabolic processes in the myocardium and the development of secondary dystrophic changes in the myocardial fibre ("secondary nonspecific cardiotoxic effect").