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The Evaluation of Myocardial Damage in 83 Young Adults with Carbon Monoxide Poisoning in the East Anatolia Region in Turkey

Department of Emergency Medicine, Ataturk University, School of Medicine, Erzurum, Turkey, saslan29{at}gmail.com

Mustafa Uzkeser

Department of Emergency Medicine, Ataturk University, School of Medicine, Erzurum, Turkey

Bedri Seven

Department of Nuclear Medicine, Ataturk University, School of Medicine, Erzurum, Turkey

Fuat Gundogdu

Department of Cardiology, Ataturk University, School of Medicine, Erzurum, Turkey

Hamit Acemoglu

Department of Medical Education, Ataturk University, School of Medicine, Erzurum, Turkey

Enbiya Aksakal

Department of Cardiology, Ataturk University, School of Medicine, Erzurum, Turkey

Erhan Varoglu

Department of Nuclear Medicine, Ataturk University, School of Medicine, Erzurum, Turkey

Carbon monoxide (CO) poisoning is the leading cause of death from intoxication. In CO poisoning, it is important to know if there are any symptoms regarding myocardial damage, which are usually unobserved as a result of hypoxia. This study was planned to assess myocardial damage in young healthy patients with CO poisoning. Eighty-three young healthy cases who had been exposed to CO were included in this study. The demographic and clinical characteristics, the origin of CO gas and smoking habits of the patients were recorded. The evaluation of ECG, peripheral ABG, complete blood count and serial cardiac biomarkers (creatine kinase, creatine kinasemyocardial band and troponin I) measurements were performed in all cases. Additionally, echocardiogram (ECHO) and myocardial perfusion single-photon emission computed tomography (SPECT) were performed at the appropriate times in all cases. The mean age of the patients was 27.39 /10.9 years. The main complaint of the patients was loss of consciousness with a 62.7% rate. The average carboxyhaemoglobin level of the patients was 34.49 /15.9%. Sinus tachycardia was present in 26.5% of patients. Diagnostic ischaemic ECG changes were present in 14.4% of patients. In myocardial SPECT, myocardial ischaemic damage was observed in 9 cases, in 6 of whom ECHO findings were also confirmed. Myocar-dial damage due to CO poisoning should not be ignored. If patients are at risk in terms of myocardial damage, further studies, such as ECHO and scintigraphy are needed to determine myocardial damage resulting from CO poisoning. However, in the young adults of the risk group, if the baseline ECG and serial cardiac biomarkers are normal, further studies such as ECHO and scintigraphy, considering the length of exposure and the severity of poisoning, may not be necessary for the evaluation of myocardial damage due to CO poisoning.

Key Words: carbon monoxide • myocardial damage • poisoning

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