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Cardiac manifestations of acute carbamate and organophosphate poisoning

A M Saadeh1, N A Farsakh, M K al-Ali

  • 1Princess Basma Teaching Hospital, Faculty of Medicine, Jordan University of Science, Irbid, Jordan.

Heart (British Cardiac Society)
|May 1, 1997
PubMed

Insights

Cardiac complications are frequent in organophosphate and carbamate poisoning, with ECG abnormalities common. Prompt intensive care and atropine can reduce mortality from these poisonings.

Area of Science:

  • Toxicology
  • Cardiology
  • Critical Care Medicine

Background:

  • Organophosphate and carbamate poisoning are significant public health concerns.
  • Cardiac complications can arise from these poisonings, impacting patient outcomes.
  • Understanding the frequency and nature of these cardiac issues is crucial for effective management.

Purpose of the Study:

  • To investigate the incidence, extent, and underlying mechanisms of cardiac complications in organophosphate and carbamate poisoning.
  • To identify predisposing factors for cardiac involvement in poisoned patients.

Main Methods:

  • A retrospective study was conducted.
  • Data were collected from 46 adult patients admitted to a medical intensive care unit (MICU) over five years.
  • Patients diagnosed with organophosphate or carbamate poisoning were included.

Main Results:

  • Cardiac complications occurred in 67% of patients, including non-cardiogenic pulmonary edema (43%) and arrhythmias (24%).
  • Electrocardiographic abnormalities were prevalent, with prolonged Q-Tc interval (67%) and ST-T changes (41%) noted.
  • Hypotension (17%) and hypertension (22%) were observed, with 17% requiring respiratory support. In-hospital mortality was 4% due to ventricular fibrillation.

Conclusions:

  • Cardiac complications are common in organophosphate and carbamate poisoning, especially within the initial hours.
  • Hypoxemia, acidosis, and electrolyte imbalances are key predisposing factors.
  • Early and aggressive supportive care, including adequate atropine dosage, in intensive or coronary care settings can decrease mortality.
Abstract

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