CLINICAL RESEARCH: CARBON MONOXIDE POISONING
Cardiovascular Manifestations of Moderate to Severe Carbon Monoxide Poisoning
Daniel Satran, MD*,
Christopher R. Henry, BS ,
Cheryl Adkinson, MD ,
Caren I. Nicholson, RN ,
Yiscah Bracha, MS and
Timothy D. Henry, MD ,*
* Division of Cardiology, University of Minnesota, Minneapolis, Minnesota
Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
Manuscript received November 4, 2004;
revised manuscript received January 19, 2005,
accepted January 25, 2005.
* Reprint requests and correspondence: Dr. Timothy D. Henry, Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 40, Minneapolis, Minnesota 55407. (Email: henry003{at}umn.edu).
OBJECTIVES: We describe the cardiovascular manifestations of carbon monoxide (CO) poisoning.
BACKGROUND: Carbon monoxide poisoning is a common cause of toxicologic morbidity and mortality. Although the neurologic sequelae of CO poisoning have been well described, the cardiovascular consequences are limited to isolated case reports.
METHODS: We reviewed the cardiovascular manifestations of 230 consecutive patients treated for moderate to severe CO poisoning in the hyperbaric oxygen chamber at Hennepin County Medical Center (HCMC), a regional center for treatment of CO poisoning.
RESULTS: The mean age was 47.2 years with 72% men. Ischemic electrocardiogram (ECG) changes were present in 30% of patients, whereas only 16% had a normal ECG. Cardiac biomarkers (creatine kinase-MB fraction or troponin I) were elevated in 35% of patients. In-hospital mortality was 5%.
CONCLUSIONS: Cardiovascular sequelae of CO poisoning are frequent, with myocardial injury assessed by biomarkers or ECG in 37% of patients. Patients admitted to the hospital with CO poisoning should have a baseline ECG and serial cardiac biomarkers.
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Abbreviations and Acronyms
| | CAD = coronary artery disease | | CO = carbon monoxide | | COHb = carboxyhemoglobin | | ECG = electrocardiogram | | GCS = Glasgow Coma Scale | | HBO2 = hyperbaric oxygen | | HCMC = Hennepin County Medical Center | | MI = myocardial infarction | | WMA = wall motion abnormality |
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