Cardiovascular manifestations of moderate to severe carbon monoxide poisoning

J Am Coll Cardiol. 2005 May 3;45(9):1513-6. doi: 10.1016/j.jacc.2005.01.044.

Abstract

Objectives: We describe the cardiovascular manifestations of carbon monoxide (CO) poisoning.

Background: Carbon monoxide poisoning is a common cause of toxicologic morbidity and mortality. Although the neurologic sequelae of CO poisoning have been well described, the cardiovascular consequences are limited to isolated case reports.

Methods: We reviewed the cardiovascular manifestations of 230 consecutive patients treated for moderate to severe CO poisoning in the hyperbaric oxygen chamber at Hennepin County Medical Center (HCMC), a regional center for treatment of CO poisoning.

Results: The mean age was 47.2 years with 72% men. Ischemic electrocardiogram (ECG) changes were present in 30% of patients, whereas only 16% had a normal ECG. Cardiac biomarkers (creatine kinase-MB fraction or troponin I) were elevated in 35% of patients. In-hospital mortality was 5%.

Conclusions: Cardiovascular sequelae of CO poisoning are frequent, with myocardial injury assessed by biomarkers or ECG in 37% of patients. Patients admitted to the hospital with CO poisoning should have a baseline ECG and serial cardiac biomarkers.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carbon Monoxide Poisoning / blood
  • Carbon Monoxide Poisoning / epidemiology*
  • Carbon Monoxide Poisoning / etiology
  • Carbon Monoxide Poisoning / mortality
  • Carbon Monoxide Poisoning / physiopathology*
  • Cardiovascular System / physiopathology*
  • Creatine Kinase / blood
  • Creatine Kinase, MB Form
  • Electrocardiography
  • Female
  • Humans
  • Isoenzymes / blood
  • Male
  • Medical Records
  • Middle Aged
  • Minnesota / epidemiology
  • Retrospective Studies
  • Severity of Illness Index
  • Troponin I / blood

Substances

  • Isoenzymes
  • Troponin I
  • Creatine Kinase
  • Creatine Kinase, MB Form