Clinical Medicine Department of Cardiology, DRK Kliniken Berlin Köpenick, Berlin, Germany.
Clinical Medicine Department of Pneumology, University Medicine Greifswald, Greifswald, Germany.
ESC Heart Fail. 2021 Aug;8(4):3403-3407. doi: 10.1002/ehf2.13389. Epub 2021 May 3.
We report on a 70-year-old woman who tried to eliminate ants from her kitchen by applying a publicly available insecticide spray. Immediately afterwards, she felt dyspnoea, superseded by heavy chest pain. High-sensitivity troponin concentration increased from 33 to 149 ng/L (cut-off 50 ng/L). Significant coronary stenosis was excluded by coronary angiography, and the myocardial damage was classified as myocardial infarction type II. After exclusion of other potential mechanisms, we consider a cardiotoxic effect of the insecticide mixture of cypermethrin, tetramethrin, and piperonyl butoxide possible. We conclude that consumer information has to be improved. This concerns sustainable control measures adapted to the target insect species (in this case, the black garden ant Lasius niger), and differentiation between authorized and non-authorized but notified products. The instructions for use should give clear information on vulnerable groups and recommend personal protective equipment. Physicians and authorities should be alert to cardiac side-effects of insecticides.
我们报告了一位 70 岁的女性，她试图用市售的杀虫剂喷雾消灭厨房中的蚂蚁。之后，她立即感到呼吸困难，随后出现严重胸痛。高敏肌钙蛋白浓度从 33 增至 149ng/L（50ng/L 为临界值）。冠状动脉造影排除了明显的冠状动脉狭窄，心肌损伤被归类为心肌梗死 II 型。排除其他潜在机制后，我们认为杀虫剂混合物氯菊酯、四氟菊酯和增效醚可能具有心脏毒性。我们的结论是，必须改进消费者信息。这涉及到针对目标昆虫物种（在这种情况下是黑花园蚁 Lasius niger）的可持续控制措施，以及区分授权和未授权但已通知的产品。使用说明应提供有关弱势群体的明确信息，并建议使用个人防护设备。医生和当局应该警惕杀虫剂的心脏副作用。
