Bane toxic left the heart hypoxic

Introduction: Acute myocardial infarction as a result of acute organophosphorous poisoning has been reported but is exceptionally rare. We present a patient with consumption of Chlorpyriphos 50% who developed acute myocardial infarction with cardiogenic shock.

Case report: A 45 year old female patient was brought to our Emergency Department with alleged history of consumption of Chlorpyriphos 50%, 2 hours prior to presentation. She had brown colored vomiting, altered sensorium. On arrival she was tachycardic, hypotensive and she had tachypnea. Initial resuscitation was done, she was started on Atropine and Pralidoxime. Crystalloid fluids bolus was given for hypotension but patient did not respond for the same hence she was started on vasopressors. Initial ECG in the ED revealed non sustained ventricular tachycardia followed by ST segment elevation in Anterior chest leads. We diagnosed it as Acute ST-Elevation myocardial infarction with cardiogenic shock. She was thrombolysed with streptokinase. But she expired after 24 hours of thrombolysis.

Conclusion: Acute myocardial infarction is a rare association with Organophosphorous poisoning. Though prognosis with organophosphorous poisoning is good with appropriate and timely treatment but when associated with acute MI, there is increased risk of mortality.