ECG CHANGES IN ALUMINIUM PHOSPHIDE POISONING

Abstract

Background: Aluminium phosphide is a solid fumigant pesticide.Aluminium phosphide (AlP) is a common suicidal poison with a high mortality rate due to its cardiovascular impact and lack of antidote. The clinical spectrum of poisoning varies depending upon the dosage and duration of consumption.The main effect of the poison is due to the release of phosphine which inhibits cytochrome oxidase and thereby hampers cellular oxygen utilization.Death is due to its direct toxic effect over the heart leading to peripheral circulatory failure.The aim of the study was to describe the electrocardiographic changes in Aluminium phosphide poisoning. Methods: 36 patients,who were admitted in MICU, following consumption of aluminium phosphide tablets were included in the study. Patients clinical evaluation was done.ECG of the patients was done to study the cardiac abnormalities. Results: Out of 36 cases,ECG was normal in 16 cases and abnormal in 20 cases. Atrial fibrillation was most common finding-6 patients (30%), supraventricular tachycardia-2 (10%),ventricular tachycardia-2 (10%),ST-T changes-6 { ST elevation-4 (20%) and ST depression-2 (10%) },bundle branch block-1 (5%),prolonged QTc-3 (15%).Conclusions: ECG was done bedside, it is a cost effective tool and should be done in all cases.Whenever it is available, it must be done in cases of aluminium phosphide poisoning. Thus, proper clinical work out along with relevant investigations and management as per standard protocol may save many more live