Tominaga Keiichiro, Izumi Manabu, Suzukawa Masayuki, Shinjo Takafumi, Izawa Yoshimitsu, Yonekawa Chikara, Ano Masaki, Yamashita Keisuke, Muronoi Tomohiro, Mochiduki Reiko
Department of Emergency and Critical Care Medicine, Jichi Medical University, Tochigi 329-0498, Japan.
Case Rep Med. 2012;2012:630468. doi: 10.1155/2012/630468. Epub 2012 Nov 19.
Background. Glufosinate ammonium has a famous delayed complication as respiratory failure, however, delayed cardiogenic complication is not well known. Objectives. The aim of this study is to report a takotsubo cardiomyopathy as a delayed complication of glufosinate ammonium for suicide attempt. Case Report. A 75-year-old woman ingested about 90 mL of Basta, herbicide for suicide attempt at arousal during sleep. She came to our hospital at twelve hours after ingesting. She was admitted to our hospital for fear of delayed respiratory failure. Actually, she felt down to respiratory failure, needing a ventilator with intubation at 20 hours after ingesting. Procedure around respiratory management had smoothly done with no delay. Her vital status had been stable, however, she felt down to circulatory failure and diagnosed as Takotsubo cardiomyopathy at about 41 hours after ingestion. There was no trigger activities or events to evoke mental and physical stresses. Conclusion. We could successfully manage takotsubo cardiomyopathy resulted in circulatory failure in a patient with glufosinate poisoning for suicide attempt. Takotsubo cardiomyopathy should be taken into consideration if circulatory failure is observed for unexplained reasons.
背景。草铵膦铵盐有一个著名的延迟并发症,即呼吸衰竭,然而,延迟的心源性并发症并不为人所知。目的。本研究的目的是报告一例应激性心肌病作为草铵膦铵盐自杀未遂的延迟并发症。病例报告。一名75岁女性在睡眠中觉醒时摄入约90毫升百草枯除草剂企图自杀。她在摄入后12小时来到我院。因担心延迟性呼吸衰竭而入院。实际上,她在摄入后20小时出现呼吸衰竭,需要插管使用呼吸机。呼吸管理相关操作顺利进行,没有延误。她的生命体征一直稳定,然而,她在摄入后约41小时出现循环衰竭,并被诊断为应激性心肌病。没有诱发精神和身体应激的触发活动或事件。结论。我们成功地处理了一名因草铵膦中毒自杀未遂患者出现的循环衰竭所致的应激性心肌病。如果观察到原因不明的循环衰竭,应考虑应激性心肌病。