Kołodziej Małgorzata, Zaleski Kamil, Majewska Magdalena, Górska Agnieszka, Kwiecień-Obara Ewelina, Szponar Jarosław
Wojewódzki Szpital Specjalistyczny im. Stefana Kardynała Wyszyńskiego, Samodzielny Publiczny Zakład Opieki, Zdrowotnej w Lublinie, Oddział Toksykologiczno-Kardiologiczny.
Samodzielny Publiczny Szpital Wojewódzki im. Jana Bozego w Lublinie, Oddział Internistyczny.
Przegl Lek. 2013;70(8):623-7.
The heart muscle is particularly sensitive to the toxic effects of carbon monoxide. Cardiovascular complications are present in 30-40% poisoned patients. Currently, multiple ECG records and at least two-time determination of cardiac markers' concentration (mainly troponin I) are known as the gold standard practice in the diagnosis of cardiac injury especially with regard to medium and severe poisoning. So far there have not been any recommendations for further diagnostic steps in case of abnormalities in these examinations. This paper presents a review of cardiac imaging techniques as well as the analysis of their usefulness in carbon monoxide poisoning. According to the authors echocardiography is considered to be an extremely important examination which, thanks to its accessibility and non-invasive nature, should be performed on all patients with myocardium injury suspicion made on the basis of clinical image, ECG records and biochemical markers.
心肌对一氧化碳的毒性作用特别敏感。30%-40%的中毒患者存在心血管并发症。目前,多次心电图记录以及至少两次测定心脏标志物浓度(主要是肌钙蛋白I)是诊断心脏损伤的金标准做法,尤其是对于中度和重度中毒。到目前为止,对于这些检查出现异常时的进一步诊断步骤尚无任何建议。本文综述了心脏成像技术,并分析了它们在一氧化碳中毒中的有用性。作者认为,超声心动图是一项极其重要的检查,由于其可及性和非侵入性,应对所有根据临床症状、心电图记录和生化标志物怀疑有心肌损伤的患者进行该项检查。