Acute Myocardial Injury and Ventricular Arrhythmia in Organophosphate Intoxication - A Case Report

有機磷中毒引起的急性心肌損傷和心室性心律不整－病歷報告

陳國勳(Kuo-Shuen Chen) ； 林明正(Ming-Cheng Lin) ； 林正盛(Cheng-Sheng Lin) ； 詹貴川(Kuei-Chuan Chan) ； 蔡青峰(Ching-Fung Tsai) ； 翁國昌(Kwo-Chang Ueng) ； 吳得進(Der-Jinn Wu) ； 林中生(Chung-Sheng Lin)

《中山醫學雜誌》 14卷3期 (2003/09) Pp. 443-448

https://doi.org/10.30096/CSMJ.200309.0007

摘要

有機磷中毒常見於國內，大部分是使用農藥不當，有機磷中毒引起的心臟併發症雖然少見，但常有致命的危險。本篇報告敘述一個48歲男性病人因誤食有機磷而住院，住院隔天心電圖呈現廣泛性的ST-T變化，顯示急性心肌損傷．接著發作心室頻脈和產生肺水腫，心導管檢查發現正常的冠狀動脈，左心室收縮功能不良，經過使用強心劑[chi1]、抗心律不整藥物、主動脈氣球幫浦和有機磷解毒劑（Atropine，PAM）的治療後，病人於二星期後病癒出院。

關鍵字

有機磷中毒 ； 心肌損傷 ； 心室性心律不整

並列摘要

Organophosphate poisonings are common in Taiwan. Most of these poisonings are due to insecticide exposure. Cardiac complications are rare in organophosphate intoxications but are potentially fatal. Herein, we described a 48 year old man admitted to Chung-Shan Medical University hospital because of accidental intake of organophosphate. Diffuse ST-T change was noted on ECG during the next day following admission, followed by ventricular tachycardia.
Acute myocardial injury with pulmonary edema ensued. Cardiac catherization revealed left ventricular global hypokinesia and normal coronary arteriography. He was treated with inotropic
agents, anti-arrhythmic agents and IABP in addition to the antidote for organophosphate (Atropine and Pralidoxime). This patient discharged two weeks later with complete recovery.

並列關鍵字

Organophosphate intoxication ； myocardial injury ； ventricular arrhythmia