Abstract
Giriş: Zehirlenmelerin neden olduğu
morbidite ve mortalitenin en yaygın sebeplerinden biride karbonmonoksit (CO)
zehirlenmesidir. Bu olgu sunumunda CO'e maruz kalan bir hastada gelişen
miyokardiyal hasarı sunmayı amaçladık.
Olgu
sunumu: Kırk dört
yaşında bayan hasta göğüs ağrısı olması nedeni ile dış merkezden acil
servisimize sevk edildi. Hasta iki gün önce CO zehirlenmesine maruz kalmış ve
dış merkezde tedavi almış. Hastanın özgeçmişinde diyabet, hipertansiyon,
hiperlipidemi, sigara kullanma ve kardiyak hastalık öyküsü yoktu. Hastanın
çekilen elektrokardiyogramında (EKG) sinüs taşikardisi mevcuttu. Hastanın göğüs
ağrısı ve troponin yüksekliği olması üzerine kardiyoloji konsültasyonu istendi.
Kardiyoloji tarafından primer perkütan koroner anjiografi yapıldı. Sonucun
normal olması nedeniyle CO zehirlenmesine bağlı miyokardiyal hasar düşünüldü.
Hastaya 2 gün tedavi verildi ve hasta şifa ile taburcu edildi.
Sonuç: CO zehirlenmesi sonucu acil
servise başvuran hastalarda CO-Hb düzeylerinin ölçümü dışında, CO'in zehirlenmesine
bağlı miyokardiyal hasar gelişebileceği düşünülerek EKG ve kardiyak enzim
takibi de yapılmalıdır.
References
- Referans 1 Basar L. Profiles of deaths due to poisoning in Turkey, Ministry of Justice Presidency of Forensic Medicine Institution (Master thesis), Istanbul 2000. Referans 2 Kurppa K, Hietanen E, Klockars M, et al. Chemical exposures at work and cardiovascular morbidity. Atherosclerosis, ischemic heart disease, hypertension, cardiomyopathy and arrhytmias. Scand J Work Environ Health 1984;10:381-388. Referans 3 Penney, DG. A review: hemodynamic response to carbon monoxide. Environ Health Perspect 1988;77:121-130. Referans 4 Annane D, Chevret S, Jars-Guincestre C, et al. Prognostic factors in unintentional mild carbon monoxide poisoning. Intensive Care Med 2001;27:1776-1781. Referans 5 Altay S, Bozbay M, Dedemoğlu M, Ayhan E, Eren M. Myocardial infarction following carbonmonoxide poisoning Cerrahpasa Medical Journal 2009;40(4): 144-147 Referans 6 Blumenthal I. Carbon monoxide poisoning, J R Soc med 2001;94(6):270–2 Referans 7 Aslan FI, Erol MK, Karcioglu O, et al. The investigation of ischemic myocardial damage in patients with carbon monoxide poisoning. Anatolian Journal of Cardiology 2005;5:189-193. Referans 8 Fiorista F, Casazza F, Comolatti G. Silent myocardial infarction caused by acute carbonmonoxide poisoning. G Ital Cardiol 1993;23:583-7. Referans 9 Gülbay BE, Onen ZP. Carbon monoxide poisoning. Turkey Clinics J Surg Med Sci 2006;2:109-112. Referans10 Stoller KP. Hyperbaric oxygen and carbon monoxide poisoning: a critical review. Neurological Research, 2007; 29:146-155
Abstract
Introduction: CO is one of the main cause of toxicities which lead to morbidity and
mortality. In the present study, we aimed to report a myocardial injury case
resulted from CO exposure.
Case Report: 44-year-old female patient admitted to our emergency service from a state
hospital with the complaint of the chest pain. The patient had been exposed to
carbon monoxide two days ago and had been taken care in the state hospital. The
patient has no cardiac problems, diabetes mellitus, hyperlipidemia and smoking
history. Her ECG was in the sinus tachycardia pattern. She was consulted to
cardiology department for chest pain and positive troponin result. She was
intervened percutaneous coronary angiography and no vascular pathology was
defined. So, she thought as myocardial injury due to CO exposure. She got
therapy in cardiology service for 2 days and discharged after full recovery.
Conclusion: In CO intoxication cases, first CO-Hb level should be analyzed.
Additionally, it must be remembered to look for presence of myocardial injury
by ECG and cardiac enzymes
References
- Referans 1 Basar L. Profiles of deaths due to poisoning in Turkey, Ministry of Justice Presidency of Forensic Medicine Institution (Master thesis), Istanbul 2000. Referans 2 Kurppa K, Hietanen E, Klockars M, et al. Chemical exposures at work and cardiovascular morbidity. Atherosclerosis, ischemic heart disease, hypertension, cardiomyopathy and arrhytmias. Scand J Work Environ Health 1984;10:381-388. Referans 3 Penney, DG. A review: hemodynamic response to carbon monoxide. Environ Health Perspect 1988;77:121-130. Referans 4 Annane D, Chevret S, Jars-Guincestre C, et al. Prognostic factors in unintentional mild carbon monoxide poisoning. Intensive Care Med 2001;27:1776-1781. Referans 5 Altay S, Bozbay M, Dedemoğlu M, Ayhan E, Eren M. Myocardial infarction following carbonmonoxide poisoning Cerrahpasa Medical Journal 2009;40(4): 144-147 Referans 6 Blumenthal I. Carbon monoxide poisoning, J R Soc med 2001;94(6):270–2 Referans 7 Aslan FI, Erol MK, Karcioglu O, et al. The investigation of ischemic myocardial damage in patients with carbon monoxide poisoning. Anatolian Journal of Cardiology 2005;5:189-193. Referans 8 Fiorista F, Casazza F, Comolatti G. Silent myocardial infarction caused by acute carbonmonoxide poisoning. G Ital Cardiol 1993;23:583-7. Referans 9 Gülbay BE, Onen ZP. Carbon monoxide poisoning. Turkey Clinics J Surg Med Sci 2006;2:109-112. Referans10 Stoller KP. Hyperbaric oxygen and carbon monoxide poisoning: a critical review. Neurological Research, 2007; 29:146-155
Details
| Subjects | Clinical Sciences |
|---|---|
| Journal Section | CASE REPORT |
| Authors | |
| Publication Date | December 18, 2017 |
| Published in Issue | Year 2017 Volume: 1 Issue: 3 |
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