Ahmad Jaffer, D'Angelo Kyla, Rivas Madalyn, Mahal Manpreet, Nookala Vikas, Kulakauskiene Dovile, Makaryus Amgad N
Department of Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA.
Department of Cardiology, Nassau University Medical Center, East Meadow, NY 11554, USA.
Clin Pract. 2021 Sep 18;11(3):679-686. doi: 10.3390/clinpract11030083.
Dilated cardiomyopathy is a subset of cardiomyopathies defined by reduced ejection fraction of less than 45% and a dilated left ventricle. While dilated cardiomyopathy is common, its etiology is not always readily evident. Paraquat is used as an herbicide worldwide and is one of the main causes of fatal poisoning in underdeveloped countries in Asia, Central America, and the Pacific Islands. The most commonly affected organs are the lungs and kidneys. However, experimental research has shown that Paraquat can affect the heart indirectly through increased vascular permeability. In vivo animal studies have shown that paraquat poisoning causes myocardial contractile dysfunction by decreased fractional shortening and cardiac remodeling. We report the first case in published literature of a 52-year-old Hispanic man with dilated cardiomyopathy strongly associated with Paraquat exposure. It is important to obtain detailed medical history and proper diagnostic work-up including work, social, and family history, and echocardiography, baseline EKG, lab work, and ischemia cardiac testing as it can lead to improved diagnostic evaluation of possible etiologies of the commonly seen dilated cardiomyopathies and help identify less well-known etiologies as seen in our patient.
扩张型心肌病是心肌病的一个子集，其定义为射血分数降低至45%以下且左心室扩张。虽然扩张型心肌病很常见，但其病因并不总是显而易见。百草枯在全球范围内用作除草剂，是亚洲、中美洲和太平洋岛屿等欠发达国家致命中毒的主要原因之一。最常受影响的器官是肺和肾。然而，实验研究表明，百草枯可通过增加血管通透性间接影响心脏。体内动物研究表明，百草枯中毒通过缩短分数降低和心脏重塑导致心肌收缩功能障碍。我们报告了文献中首例一名52岁西班牙裔男性扩张型心肌病与百草枯接触密切相关的病例。获取详细的病史和进行适当的诊断检查很重要，包括工作、社交和家族史，以及超声心动图、基线心电图、实验室检查和缺血性心脏检查，因为这有助于改善对常见扩张型心肌病可能病因的诊断评估，并有助于识别像我们患者中所见的不太知名的病因。
