ECG CHANGES AS A MANIFESTATION OF CARDIAC COMPLICATIONS OF ORGANO PHOSPHORUS COMPOUND POISIONING

Abstract

To study the extent, frequency and pathogenesis of the cardiac and electrocardiographical manifestations of acute organophosphate poisoning. 37 adult patients admitted over a three-year period with a diagnosis of acute organophosphate was studied prospectively. The clinical features and electrocardiographical nding were recorded.Cardiac complications developed in 23 patients (62.2 percent). These were: noncardiogenic pulmonary oedema in eight cases (21.6 percent), electrocardiographical abnormalities including prolonged Q-Tc interval in 14 cases (37.8 percent), ST-T changes in 11 cases (29.7 percent), and conduction defects in two cases (5.4 percent). Sinus tachycardia occurred in 15 patients (40.5 percent) and sinus bradycardia in seven patients (18.9 percent). Hypertension developed in ve patients (13.5 percent) and hypotension in four patients (10.8 percent). Five patients (13.5 percent) needed respiratory support because of respiratory depression of which two patients developed intermediate syndrome. Out of 14 patients with prolonged Q-Tc interval, only one had polymorphic ventricular tachycardia of the torsade de pointes type. Two patients died from noncardiogenic pulmonary oedema and one from ventricular brillation, giving a hospital mortality of 8.1 percent.Cardiac complications usually occur during the rst hour after exposure. Hypoxemia, electrolyte derangements and acidosis are major predisposing factors for the development of these complications. Intensive supportive treatment, meticulous respiratory care and administration of atropine in adequate doses very early in the course of the illness will reduce the mortality