Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Eur Rev Med Pharmacol Sci. 2019 Aug;23(16):7128-7134. doi: 10.26355/eurrev_201908_18758.
Carbon monoxide is produced by the incomplete combustion of organic fuel. In the United States, it is responsible for about 500 deaths annually. Increased carboxyhemoglobin concentration and hypoxia disrupt cardiac myocyte integrity and cause dysrhythmias, acute cardiac failure and coronary artery disease. We described a case of a patient with CO-poisoning and ST elevation at ECG precordial leads who developed severe transient heart failure.
A 57-year-old man was admitted to the emergency department for acute carbon monoxide poisoning that led to respiratory and cardiac failure. The electrocardiogram showed ST elevation in precordial leads, but the coronary angiography was normal. The patient was successfully treated and discharged. Three days later he was readmitted for similar symptoms and subsequently died. We hypothesize that the ECG findings were related to transient coronary vasospasm due to CO poisoning and that acute respiratory and cardiac failure related to carbon monoxide toxicity caused death.
The management of patients poisoned by carbon monoxide requires early identification and intensive treatment and a careful evaluation of the home environment prior to discharge. ST elevation in such patients may be related to coronary vasospasm.
一氧化碳是有机燃料不完全燃烧产生的。在美国，它每年导致约 500 人死亡。升高的碳氧血红蛋白浓度和缺氧会破坏心肌细胞的完整性，导致心律失常、急性心力衰竭和冠状动脉疾病。我们描述了一例一氧化碳中毒患者，其心电图前导导联 ST 段抬高，并发严重的一过性心力衰竭。
一名 57 岁男性因急性一氧化碳中毒导致呼吸和心脏衰竭而被收入急诊。心电图显示前导导联 ST 段抬高，但冠状动脉造影正常。患者经成功治疗后出院。3 天后，他因类似症状再次入院，随后死亡。我们推测心电图的发现与一氧化碳中毒引起的短暂性冠状动脉痉挛有关，而与一氧化碳毒性相关的急性呼吸和心力衰竭导致了死亡。
对一氧化碳中毒患者的治疗需要早期识别和强化治疗，并在出院前仔细评估家庭环境。此类患者的 ST 段抬高可能与冠状动脉痉挛有关。
