A Study of Cardiac Involvement in Organophosphorus Poisoning
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 10
Abstract
Background and Objective: Organophosphorous (OP) poisoning frequently causes ill-health and death, particularly in developing countries. Not many clinical studies have been done to demonstrate the myocardial injury in OP poisoning through assessment of the cardiac biochemical markers. Hence, this is an attempt to study the myocardial injury in OP poisoning and to determine how it affects the outcome. Materials and Methods: Patients with history of OP poison consumption who fulfil the inclusion and exclusion criteria, getting admitted.Method of Collecting Data: A total of 50 cases of OP poisoning meeting inclusion criteria of the present study have been studied. Results: In this study, which included 50 patients of OP poisoning cases, tachycardia (30%) was the most common clinical sign seen, followed by bradycardia (20%), hypertension (16%), and hypotension (10%). The most common electrocardiographic abnormality seen was ST elevation (32%), followed by sinus tachycardia (30%), Q-T prolongation (24%), and sinus bradycardia (20%). Raised cardiac enzymes (troponin T and creatinine phosphokinase-MB [CK-MB]) were seen in 5 (10%) patients on the day 3. The levels of troponin T and CK-MB were elevated in patients with respiratory failure compared to non-failure ones. Patients who went into respiratory failure showed a mean troponin T and CK-MB levels of 0.0895 ± 0.01 ng/ml and 34.65 ± IU/L, respectively. The mean troponin T and CK-MB level in a patient who died were 0.1142 ± ng/ml and 39.14 ± IU/L, respectively. Conclusion: OP compound can directly cause myocardial injury during the acute phase. Cardiac complications of OP poisoning can be life threatening and are not fully appreciated. The level of cardiac enzymes correlated well with the severity of poisoning and prognosis, suggesting its use as a prognostic indicator of OP poisoning. Vigilant monitoring of the patients for prominent cardiac manifestations such as QT prolongation, VT or VF, and prompt treatment can save many patients.
Authors and Affiliations
Dr Rangaswamy, M S Bharath
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