A Rare Cause of Chest Pain: Disseminated Elemental Mercury Microthromboembolism

Brandon Allen,Lars K Beattie,Bobby Desai

doi:10.4236/crcm.2016.51003

Abstract

Background: The clinical manifestations of mercury poisoning vary based on chemical form, dose, and route of administration. In the medical field, many of the cases of mercury exposure have been in mining agriculture, or chemical industrial workers via inhalation. Aim: To discuss the diagnosis of parenteral mercury poisoning with radiographic identification and potential sequelae. Case Presentation: We present the case of a young male with a chief complaint of chest pain and intravenous mercury administration found to be intentional as a suicide attempt. The chest radiographs lead to a wide differential diagnosis in a hemodynamically stable patient. Conclusion: While ingestion rarely causes toxicity due to the poor absorption of mercury through the gastrointestinal tract, intravenous elemental mercury can range from producing minimal symptoms to being severely toxic.

Highlights

Mercury has been used widely for many centuries in various treatment modalities and medical instruments
There have been a few published cases of intravenous metallic mercury injection over the past 30 years most commonly found in patients who are younger males
While some patients with disseminated elemental mercury microthromboembolism have reportedly presented with fever, cough, GI symptoms, gingivitis, intention tremor, and/or bizarre behavior, this patient was unique as he only had symptoms of severe chest pain [5]

Summary

Introduction

Mercury has been used widely for many centuries in various treatment modalities and medical instruments. Chronic exposure to vapor of mercury has been reported to result in neurologic symptoms like weakness, ataxia, and tremors. Toxicity with metallic mercury injection, acquired both accidentally, and following attempted suicide is extremely rare. There have been a few published cases of intravenous metallic mercury injection over the past 30 years most commonly found in patients who are younger males. (2016) A Rare Cause of Chest Pain: Disseminated Elemental Mercury Microthromboembolism. The clinical manifestations of mercury poisoning vary based on chemical form, dose, and route of administration. Many of the cases of mercury exposure have been in mining agriculture, or chemical industrial workers via inhalation. Case Presentation: We present the case of a young male with a chief complaint of chest pain and intravenous mercury administration found to be intentional as a suicide attempt. Conclusion: While ingestion rarely causes toxicity due to the poor absorption of mercury through the gastrointestinal tract, intravenous elemental mercury can range from producing minimal symptoms to being severely toxic

Objectives

Discussion

Conclusion