Abstract

Methanol intoxication presented with acute coronary syndrome

Highlights

  • Methyl alcohol is a colourless, volatile liquid which is used in industry, agriculture and sometimes used for alcholic beverages

  • The coronary angiography revealed 90% occlusion of the obtuse marginal (OM) branch of the circumflex artery, critical stenosis (70%) of the left anterior descending artery (LAD) and diagonal branch of LAD, 40% occlusion of the right coronary artery with thrombolysis in myocardial infarction (TIMI) grade 3 flow (Figures 2A-2C)

  • Metabolic acidosis with an elevated anion gap along with ocular, gastrointestinal and neurological symptoms are suggestive of the diagnosis of methanol intoxication, these are often not specific to methanol poisoning

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Summary

Introduction

Methyl alcohol (methanol) is a colourless, volatile liquid which is used in industry, agriculture and sometimes used for alcholic beverages. Methanol metabolizes in the liver rapidly and its metabolites cause a metabolic acidosis with an elevated anion gap. If the diagnosis of methanol intoxication is not made and its treatment is not initiated promptly, it can result in death [1,2]. The patient underwent coronary angiography for subacute inferior myocardial infarction. Despite the sodium bicarbonate treatment, metabolic acidosis persisted, the patient had no urine output and did not wake up. An elevated anion gap (25-30 mmol/L) suggested intoxication and hemodialysis was scheduled. When severely persistent hypotension developed, ultrafiltration was discontinued and high dose inotropic theraphy was administered. Despite the treatments, he died on hospital day 2

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