carbon monoxide poisoning symptoms periodically

The electronic hospital records were searched based on the patient’s diagnosis at discharge. Inclusion criteria consisted of patients admitted through the emergency department (ED) with at least one of the following: history of CO exposure, increased COHgb levels, and symptoms consistent with CO poisoning. We included all patients aged over 18 with a diagnosis of CO poisoning between 1 January 2013 and 31 December 2021. We carried out a retrospective study in “Saint Spiridon” Regional Emergency Hospital, Toxicology Department, a tertiary regional centre for clinical toxicology in northeast Romania. In this retrospective study, we aim to analyse and describe our experience regarding cardiovascular events in the context of acute CO poisoning, focusing on ACS in relation to the severity of CO intoxication, comorbidities, clinical and biological characteristics, and outcome of patients.Ģ.1. Furthermore, CO can induce coronary spasm and intracoronary thrombosis and increase vascular permeability and platelet aggregation, which can lead to ACS both on healthy and non-critical atherosclerotic plaque. Its toxicity is the result of hypoxia, increased carboxyhaemoglobin (CoHgb) formation and direct CO-mediated cell damage. ĬO has a specific effect on highly sensitive tissues to hypoxia, such as brain or heart.

In Europe, national data provided by 28 European member states on CO poisoning reported an annual rate of 2.2/100,000 CO-related deaths. Cumulative worldwide incidence and mortality of CO poisoning are currently estimated at 137 cases and 4.6 deaths per million, respectively.

Carbon monoxide (CO) poisoning, through different mechanisms, can be the cause of ACS.ĬO poisoning is a major public health problem, being one of the leading causes of death and injury worldwide. Spasm, obstruction, inflammation, or trauma of the coronary arteries can cause myocardial injury. There are other rare causes of ACS, such as endocrine or haematological. The most common cause of ACS is atherosclerosis (90%), which is frequently complicated, leading to partial or complete thrombosis of infarct-related coronary artery. It is represented by a spectrum of clinical and paraclinical presentations, ranging from ST-segment elevation myocardial infarction (STEMI) to non–ST-segment elevation myocardial infarction (NSTEMI) or unstable angina. While in-hospital mortality in our study was low, further prospective studies should investigate the long-term mortality in these patients.Īcute coronary syndrome (ACS) is a consequence of a sudden imbalance between oxygen demand and supply to the myocardium. We found that the severity of CO poisoning plays an important role in developing myocardial injury, as 50% of patients in the event group were severely intoxicated. Our study introduces new information on adverse cardiac events in patients with CO poisoning, focusing on the ACS. Myocardial injury can develop in CO poisoning irrespective of the severity of poisoning, and it can be transient, reversible, or permanent. The STEMI group had a mean age of 27.7 years old and no comorbidities. Most of the patients in the STEMI (50%) and NSTEMI (66.7%) groups had severe CO intoxication. Cardiac enzyme markers (troponin and creatin-kinase MB) had a statistically significant increase in the event group compared to the non-event group ( p < 0.05). The severity of poisoning did not correlate with myocardial injury however, 50% of the event group had severe poisoning with carboxyhaemoglobin ≥ 20%. A total of 65 patients were included, 22 in the event and 43 in the non-event group.

We divided the cohort into event group (myocardial injury) and non-event group (patients without myocardial injury) and performed a subset analysis of the former. We have conducted a retrospective study in the Toxicology Department of Saint Spiridon Emergency University Hospital, including all patients admitted through the emergency department with CO poisoning. Through tissue hypoxia and direct cell injury, CO poisoning can lead to a broad spectrum of cardiac disorders, especially ACS. The most common cause is atherosclerosis however, other rare causes such as carbon monoxide (CO) poisoning should be considered. Acute coronary syndrome (ACS) is a spectrum of clinical and paraclinical disorders arising from an imbalance of oxygen demand and supply to the myocardium.

Carbon monoxide poisoning symptoms periodically