Mittal Nitish, Elmassry Mohamed, Abohelwa Mostafa
Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas.
Division of Cardiology, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Proc (Bayl Univ Med Cent). 2022 Nov 3;36(2):224-225. doi: 10.1080/08998280.2022.2136920. eCollection 2023.
Zinc phosphide toxicity is a rare entity that presents most frequently among farmers in developing countries who use it as a rodenticide. The phosphine gas released after the ingestion inhibits cytochrome c oxidase, disrupting the mitochondrial physiology and oxidative phosphorylation and causing myocardial stunning. Here we present a case of a 20-year-old man who attempted suicide with zinc phosphide toxicity. Initially, he was hemodynamically stable with a normal ejection fraction; however, in a few hours, he deteriorated quickly and became hemodynamically unstable, with rapid deterioration of his ejection fraction to 20%. He was started on norepinephrine and then dobutamine; however, he had cardiac arrest from refractory cardiogenic shock despite resuscitative measures.
磷化锌中毒是一种罕见情况，在发展中国家将其用作灭鼠剂的农民中最为常见。摄入后释放的磷化氢气体抑制细胞色素c氧化酶，破坏线粒体生理功能和氧化磷酸化，导致心肌顿抑。在此，我们报告一例20岁男性因磷化锌中毒企图自杀的病例。最初，他血流动力学稳定，射血分数正常；然而，数小时后，他迅速病情恶化，血流动力学不稳定，射血分数迅速降至20%。他开始使用去甲肾上腺素，随后使用多巴酚丁胺；然而，尽管采取了复苏措施，他仍因难治性心源性休克发生心脏骤停。
