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ST Elevation Myocardial Infarction Due to Carbon Monoxide Toxicity
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A6936 - ST Elevation Myocardial Infarction Due to Carbon Monoxide Toxicity
Author Block: G. Eisinger1, C. Kaide2, J. E. Stasek3; 1Emergency and Internal Medicine, The Ohio State University, Columbus, OH, United States, 2Emergency Medicine, The Ohio State University, Columbus, OH, United States, 3Pulmonary Disease and Critical Care Medicine, The Ohio State Univ College of Medicine, Columbus, OH, United States.
We describe the case of a previously healthy 27-year-old male patient who presented with altered mental status, was found to have significant carbon monoxide (CO) toxicity, and developed myocardial injury consistent with ST-elevation myocardial infarction (STEMI) during the initial hours of his admission. At left-heart catheterization, no atherosclerotic disease or coronary thrombus was detected. Echocardiography revealed global myocardial dysfunction with reduced ejection fraction. Although myocardial injury is a known complication of CO toxicity, only a small number of cases of STEMI have been described. In the majority of these cases, patients were found to have obstructive coronary lesions on left-heart catheterization, even in the absence of existing coronary artery disease or risk factors for its development. We will discuss similarities and differences between our patient and the previously described cases, as well as proposed mechanisms of pathogenesis and the role of heart catheterization and hyperbaric oxygen in management.
Author Block: G. Eisinger1, C. Kaide2, J. E. Stasek3; 1Emergency and Internal Medicine, The Ohio State University, Columbus, OH, United States, 2Emergency Medicine, The Ohio State University, Columbus, OH, United States, 3Pulmonary Disease and Critical Care Medicine, The Ohio State Univ College of Medicine, Columbus, OH, United States.
We describe the case of a previously healthy 27-year-old male patient who presented with altered mental status, was found to have significant carbon monoxide (CO) toxicity, and developed myocardial injury consistent with ST-elevation myocardial infarction (STEMI) during the initial hours of his admission. At left-heart catheterization, no atherosclerotic disease or coronary thrombus was detected. Echocardiography revealed global myocardial dysfunction with reduced ejection fraction. Although myocardial injury is a known complication of CO toxicity, only a small number of cases of STEMI have been described. In the majority of these cases, patients were found to have obstructive coronary lesions on left-heart catheterization, even in the absence of existing coronary artery disease or risk factors for its development. We will discuss similarities and differences between our patient and the previously described cases, as well as proposed mechanisms of pathogenesis and the role of heart catheterization and hyperbaric oxygen in management.
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