Evaluation of the potential cardiotoxic effects in acute organophosphate toxicity as a prognostic factor

Abstract

Background/aim Organophosphorus compounds are the most commonly used pesticides as a result of their easy availability. They are highly toxic compounds for human beings. The study aimed to evaluate the potential cardiotoxic effects in acute organophosphate toxicity as a prognostic factor. Patients and methods This study was carried out on 48 organophosphate acutely intoxicated adult patients. All participants were subjected to the following: sociodemographic study, patient’s history, clinical examination, laboratory investigations, ECG (ECG changes were graded as minor, moderate, and severe), and echocardiography. Results Regarding acute organophosphorus poisoning (OPP) severity, patients with mild, moderate, and severe intoxication represented 18.6, 35.4, and 45.8 of the studied patients, respectively. Of acute OPP patients, 81.25% had abnormal ECG with ischemic changes in 66.7% of patients and arrhythmia in 43.6%. Inverted T-wave and elevated ST segment were the most frequent among ischemic findings while atrial fibrillation was the most frequent arrhythmic finding. The ECG changes induced by acute OPP were graded as moderate in 68.75% of patients and severe in 12.5%. Only one case of acute OPP was diagnosed as acute myocardial infarction. No cases with minor ECG grading were recorded. There was a statistically significant difference between acute OPP severity and ECG grading. Patients with acute OPP have shown a mean QTc interval of 0.46±0.062 s. In all, 47.9% of patients reported prolonged QTc interval. QTc interval was significantly more prolonged in severely intoxicated patients. Conclusion ECG grading and corrected QT interval are a predictor for both primary and major outcome in patients with acute OPP.