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Transient myocardial dysfunction in a child with salicylate toxicity
M E Ralston1, P D Pearigen, M L Ponaman
1Department of Pediatrics, Naval Medical Center, San Diego, California 92134-5000, USA.
The Journal of Emergency Medicine
|September 1, 1995
Summary
Aspirin overdose can cause heart problems in children, including myocardial depression. This case report highlights the potential for salicylate toxicity to induce reversible myocardial dysfunction and pulmonary edema in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Toxicology
- Critical Care Medicine
Background:
- Aspirin overdose (salicylate toxicity) is a common pediatric poisoning with known systemic effects.
- Myocardial depression is not typically reported in pediatric salicylate poisoning.
- Typical complications include acid-base disturbances, electrolyte abnormalities, and central nervous system effects.
Observation:
- A 13-month-old boy presented with aspirin intoxication.
- The child exhibited clinical, radiographic, and echocardiographic signs of myocardial impairment.
- This included pulmonary edema and global left ventricular dysfunction (shortening fraction of 23%).
Findings:
- The case demonstrates myocardial dysfunction in a child following toxic aspirin ingestion.
- Echocardiography confirmed moderate global left ventricular dysfunction.
- Complete resolution of myocardial impairment was observed upon recovery from intoxication.
Implications:
- This case suggests myocardial dysfunction is a potential complication of severe salicylate poisoning in children.
- Salicylate-induced myocardial impairment may contribute to the development of pulmonary edema.
- Pediatricians should consider cardiac evaluation in children with significant aspirin overdose.