Abstract
Background:—The Yellow Oleander is an ornamental tree that is common throughout the tropics. Ingestion of its seeds results in a clinical picture similar to digoxin toxicity.Objectives:—The aim of this study was to evaluate cardiac findings in acute Yellow Oleander poisoning.Methods and Materials: —A total of 21 patients with history of Yellow Oleander ingestion were enrolled in this study.Results:—All symptomatic patients had conduction defects affecting the sinus node, theatrio-ventricular node or both. Patients showing cardiac arrhythmias that required specific management had significantly higher serum potassium concentrations.Conclusion: —Most of the symptomatic patients had conduction defects affecting sinus or atrio-ventricular nodes but few had atrial or ventricular arrhythmias typical of digoxin poisoning.
Highlights
The Yellow Oleander is an ornamental tree of the Apocyanaceae family that is common throughout the tropics.[1]
A total of 21 patients [53 ± 9.7 yrs; 17 female] with a history of Yellow Oleander seed ingestion presenting to Faghihi General Hospital were enrolled in the study
All patients with second or third degree AV block, prominent sinus bradycardia [< 40 /min], atrial or ventricular tachyarrhythmias were transferred to coronary care unit
Summary
The Yellow Oleander is an ornamental tree of the Apocyanaceae family that is common throughout the tropics.[1] It contains cardiac glycosides that are toxic to cardiac myocytes and autonomic nervous system.[1,2] Ingestion of its seeds results in poisoning similar to digoxin toxicity.[1,3] Severely affected patients may manifest as resistant ventricular fibrillation.[1,4] Intermediate poisoning may manifest as first degree atrio-ventricular (AV) block with progression to AV dissociation. 3,5 The aim of this study was to evaluate cardiac findings and management of acute Yellow Oleander poisoning in southern Iran. Serum potassium (K+), Sodium (Na+) and Calcium (Ca2+) were analyzed at the Department of Chemical Laboratory [Faghihi Hospital]. Renal function including blood urea nitrogen [BUN], creatinine and liver function indices including SGOT, SGPT, PT and serum protein were analyzed in the clinical laboratory of Faghihi General Hospital using standard automated techniques
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