NDLI: Evaluation of Cardiac Function Using Transthoracic Echocardiography in Patients with Myocardial Injury Secondary to Methomyl Poisoning

Content Provider	Springer Nature Link
Author	Lee, Dong Keon Cho, Nam Hyub Kim, Oh Hyun Go, Jin Kim, Tae Hoon Cha, Kyoung Chul Kim, Hyun Lee, Kang Hyun Hwang, Sung Oh Cha, Yong Sung
Copyright Year	2014
Abstract	Generally, the mortality rate for cases of carbamate poisoning is low, but fatalities secondary to methomyl poisoning have been reported including a case report of cardiac toxicity following short-term exposure to methomyl. There have been no reports, however, regarding patterns of cardiac toxicity after exposure to methomyl. Therefore, we investigated the prevalence and patterns of myocardial injury using a biochemical marker, troponin I (TnI), and evaluated cardiac function using transthoracic echocardiography (TTE). We conducted a retrospective review of 14 consecutive methomyl poisoning cases that were diagnosed and treated at the emergency department of the Wonju Severance Christian Hospital between January 2009 and December 2013. On ECG analysis, ST depression and T-wave inversion were seen in five patients (35.7 %) and one patient (7.1 %), respectively. On cardiac biochemical marker analysis, initial TnI was elevated in 11 patients (78.6 %). TTE was performed in nine patients among the 11 patients in whom TnI was found to be elevated. Of the nine patients that underwent TTE, three patients (33.3 %) showed a reduced ejection fraction (EF), and RWMA was noted in two patients. There were two patients (22.2 %) that had both reduced systolic function and RWMA. One patient did not regain normal systolic function on admission. None of the three patients with reduced EF received any specific treatment to support cardiac function. One patient expired due to pneumonia, and one patient was transferred as moribund. We followed up on 12 patients who survived to discharge for 6–44 months. One patient (8.3 %) was died to follow-up, and 11 patients survived without any further complications. Methomyl exposure can cause direct myocardial injury and reversible cardiac dysfunction. Monitoring of TnI levels and TTE for evaluation of cardiac function may be useful in the workup of patients suffering from methomyl poisoning.
Starting Page	269
Ending Page	275
Page Count	7
File Format	PDF
ISSN	15307905
Journal	Cardiovascular Toxicology
Volume Number	15
Issue Number	3
e-ISSN	15590259
Language	English
Publisher	Springer US
Publisher Date	2014-11-20
Publisher Place	New York
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Carbamate Methomyl Troponin I Echocardiography Electrocardiogram Pharmacology/Toxicology Cardiology
Content Type	Text
Resource Type	Article
Subject	Molecular Biology Toxicology Cardiology and Cardiovascular Medicine

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