Myocardial infarction with normal coronary artery after carbon monoxide exposure: a case report

Carbon monoxide intoxication usually disturbs the normal human biochemical respiratory chain cascade from which high affinity of carboxyhemoglobin to oxygen causes ischemic insult to the human tissues and cells. Ubiquitous injuries to human cells have already been well documented for a long period of time. Here we reported a 42-year-old female who was sent to the medical emergent unit under the suspicion of carbon monoxide exposure mainly with neurologic deficits. Serum carboxyhemoglobin level was found to be 18%. Serial revolutional changes of serum CK level and ECG were noted. The echocardiogram showed hypokinesia of left ventricular apical lateral wall. Normal coronary arteriogram was found in later admission date. The patient received hyperbaric oxygen therapy and was discharged with residual psychotic symptoms. This report presented normal coronary arteriogram with serial EKG and biochemical changes in a victim of CO intoxication with evidence of myocardial infarction. Impaired oxygen delivery and disturbed intracellular mitochondrial metabolism were considered to be responsible for the ischemic insult associated with carbon monoxide exposure. The role of hyperbaric oxygen therapy was also discussed in this report; however, more experiences in application are needed to determine it's benefits for patients.