Silent Acute Coronary Syndrome in a Mild Carbon Monoxide Poisoning

Eid, Mustafa Mahmood

doi:10.2478/jce-2020-0006

Abstract

Introduction: Carbon monoxide (CO) poisoning continues to be challenging in diagnosis and management. The complications related to CO poisoning are variable and unpredictable.

Case presentation: We present the case of a 73-year-old woman who was involved in an indoor fire. Although she was asymptomatic and had a low CO level, she developed an acute coronary syndrome. The condition of the patient recovered remarkably after treatment with oxygen supplementation and anti-ischemic drugs.

Conclusion: This case indicates that an acute coronary syndrome could represent a complication of CO poisoning even in asymptomatic patients with low levels of COHb.

References

1. Harper A, Croft-Baker J. Carbon monoxide poisoning: undetected by both patients and their doctors. Age Ageing. 2004;33:105-109. doi: 10.1093/ageing/afh038.10.1093/ageing/afh03814960423
Search in Google Scholar Back to article
2. Tomaszewski C. Carbon monoxide poisoning. Early awareness and intervention can save lives. Postgrad Med. 1999;105:39-50. doi: 10.3810/pgm.1999.01.496.10.3810/pgm.1999.01.4969924492
Search in Google Scholar Back to article
3. Lee FY, Chen WK, Lin CL, et al. Carbon monoxide poisoning and subsequent cardiovascular disease risk: a nationwide population-based cohort study. Medicine (Baltimore). 2015;94:e624. doi: 10.1097/MD.0000000000000624.10.1097/MD.0000000000000624460247725761191
Search in Google Scholar Back to article
4. Satran D, Henry CR, Adkinson C, et al. Cardiovascular Manifestations of Moderate to Severe Carbon Monoxide Poisoning. J Am Coll Cardiol. 2005;45:1513-1516. doi: 10.1016/j. jacc.2005.01.044.
Search in Google Scholar Back to article
5. Barrett L, Danel V, Faure J. Carbon monoxide poisoning, a diagnosis frequently overlooked. J Clin Toxicol. 1985;23:309-313. doi: 10.3109/15563658508990638.10.3109/155636585089906384057321
Search in Google Scholar Back to article
6. Rose JJ, Wang L, Xu Q, et al. Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy. Am J Respir Crit Care Med. 2017;195:596-606. doi: 10.1164/rccm.201606-1275CI.10.1164/rccm.201606-1275CI536397827753502
Search in Google Scholar Back to article
7. Kao LW, Nañagas KA. Carbon monoxide poisoning. Emerg Med Clin N Am. 2004;22:985-1018. doi:10.1016/j.emc.2004.05.003.10.1016/j.emc.2004.05.00315474779
Search in Google Scholar Back to article
8. Wolf SJ, Maloney GE, Shih RD, et al. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Acute Carbon Monoxide Poisoning. Ann Emerg Med. 2017; 69:98-107.e6. doi: 10.1016/j.annemergmed.2016.11.003.10.1016/j.annemergmed.2016.11.00327993310
Search in Google Scholar Back to article
9. Hampson NB, Piantadosi CA, Thom SR, et al. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186:1095-1101. doi: 10.1164/rccm.201207-1284CI.10.1164/rccm.201207-1284CI23087025
Search in Google Scholar Back to article
10. Satran D, Henry CR, Adkinson C, et al. Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. J Am Coll Cardiol. 2005;45:1513-1516. doi: 10.1016/j. jacc.2005.01.044.
Search in Google Scholar Back to article
11. Henry CR, Satran D, Lindgren B, et al. Myocardial injury and long-term mortality following moderate to severe carbon monoxide poisoning. JAMA. 2006;295:398-402. doi: 10.1001/jama.295.4.398.10.1001/jama.295.4.39816434630
Search in Google Scholar Back to article

Silent Acute Coronary Syndrome in a Mild Carbon Monoxide Poisoning

Abstract

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