Intractable Ventricular Arrhythmia Induced by Aconite and its Successful Treatment with Extracorporeal Membrane Oxygenation Support
Journal of the Korean Society of Emergency Medicine
; : 471-475, 2014.
Article
em En
| WPRIM
| ID: wpr-126647
Biblioteca responsável:
WPRO
ABSTRACT
Aconite, derived from the roots of certain aconitum species (Racunculaceae), is widely distributed in Korea. Aconitine, an extremely toxic substance present in aconite, has pharmacological effects, including anti-inflammatory, analgesic, and positive inotropic actions. Due to its relatively low safe dose, we sometimes encounter cases of serious aconite intoxication. The toxic compound mainly affects the CNS, heart, and muscle tissues, resulting primarily in cardiovascular complications. Aconite poisoning presents with a combination of neurological, cardiovascular, and gastrointestinal features. The main cause of death is severe cardiotoxicity causing refractory ventricular tachyarrhythmias and asystole. As there is no specific antidote, management of aconite poisoning is supportive. All patients require close monitoring of blood pressure and cardiac rhythm since ventricular arrhythmias may occur during the first 24 hours of poisoning, resulting in sudden deterioration in the patient's clinical condition. Extracorporeal membrane oxygenation (ECMO) has traditionally been utilized for perioperative cardiac failure and cardiomyopathies. More recently, the indications for ECMO have expanded to patients with acute cardiovascular decompression including intractable arrhythmias. We report on a patient who developed life threatening ventricular tachyarrhythmia after ingestion of herbal tablets containing aconite alkaloids. Our patient was resuscitated with intravenous infusion of amiodarone, repeated cardioversion/defibrillation, and mechanical circulatory support with ECMO.
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Índice:
WPRIM
Assunto principal:
Intoxicação
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Arritmias Cardíacas
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Comprimidos
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Taquicardia
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Aconitina
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Pressão Sanguínea
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Infusões Intravenosas
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Oxigenação por Membrana Extracorpórea
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Causas de Morte
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Taquicardia Ventricular
Limite:
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Journal of the Korean Society of Emergency Medicine
Ano de publicação:
2014
Tipo de documento:
Article