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What do we know about carbon monoxide poisoning and cardiac compromise?

2015-09-01Artigo científico Acesso aberto
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dc.contributor.authorCardiga, Rosa
dc.contributor.authorProença, Margarida
dc.contributor.authorCarvalho, Carolina
dc.contributor.authorCosta, Luís
dc.contributor.authorBotella, Arturo
dc.contributor.authorMarques, Filipa
dc.contributor.authorPaulino, Carolina
dc.contributor.authorCarvalho, António
dc.contributor.authorFonseca, Cândida
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSociedade Portuguesa de Cardiologia | Elsevier
dc.date.accessioned2023-01-13T22:12:06Z
dc.date.available2023-01-13T22:12:06Z
dc.date.issued2015-09-01
dc.description.abstractCarbon monoxide (CO) poisoning is one of the most common types of poisoning and the leading cause of death by poisoning worldwide. Cardiac injury caused by CO poisoning has been little described despite being a predictor of poor prognosis. We present the case of a healthy 24-year-old woman, admitted to our emergency room due to an episode of lipothymia without loss of consciousness. She reported holocranial headache for the previous two weeks associated with nausea and vomiting. Laboratory tests revealed blood gas analysis: pH 7.392, pCO2 32 mmHg, pO2 101 mmHg, lactate 3.5 mmol/l, HCO3 20.8 mmol/l; COHb 29.2%; serial troponin I 1.21→5.25→6.13→3.65 μg/l; myoglobin 1378→964→352 μg/l; and NT-proBNP 1330 pg/l. The electrocardiogram showed sinus rhythm, heart rate 110 bpm, and ST-segment depression of 2 mm in V4 and 1 mm in V5. Transthoracic echocardiography revealed a left ventricle with normal wall motion and preserved ejection fraction. Given the clinical and epidemiological context, myocardial and central nervous system ischemia due to prolonged CO exposure was assumed and normobaric oxygen therapy was immediately started. In view of evidence of injury to two major organ systems the indication for hyperbaric oxygen therapy was discussed with a specialist colleague, who suggested maintaining conservative treatment with oxygen therapy and in-hospital monitoring for 72 h. The patient was discharged on the third day and was still asymptomatic at 400 days of follow-up. Besides symptoms and signs of central nervous system dysfunction, myocardial damage should also always be considered in the context of CO poisoning. Hyperbaric therapy is still controversial and the lack of objective data highlights the need for new randomized studies.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent811381
dc.identifier.doi10.1016/j.repc.2015.01.006
dc.identifier.issn0870-2551
dc.identifier.otherPURE: 18178518
dc.identifier.otherPURE UUID: 21134218-6be5-4779-b710-c3abd69e472e
dc.identifier.otherScopus: 84941423017
dc.identifier.otherPubMed: 26232341
dc.identifier.otherWOS: 000363047400009
dc.identifier.urihttp://hdl.handle.net/10362/147524
dc.identifier.urlhttps://www.scopus.com/pages/publications/84941423017
dc.language.isoeng
dc.peerreviewedyes
dc.subjectCarbon monoxidepoisoning
dc.subjectHyperbaric oxygen
dc.subjectMyocardial ischemia
dc.subjectCardiology and Cardiovascular Medicine
dc.titleWhat do we know about carbon monoxide poisoning and cardiac compromise?en
dc.typejournal article
degois.publication.firstPage557e1
degois.publication.issue9
degois.publication.lastPage557e5
degois.publication.titleRevista Portuguesa de Cardiologia
degois.publication.volume34
dspace.entity.typePublication
rcaap.rightsopenAccess

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