Title: A Study on Cardiac Arrhythmia in Patients with Aluminium Phosphide Poisoning in North Bihar
Authors: Dr S.C. Jha, Dr Abhinandya Mukhopadhyay, Dr B.K. Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.202
Abstract
Background: Cardiac failure is a major lethal consequence of aluminum phosphide (AlP) poisoning. This study was designed to know the frequency of cardiac arrhythmias in patients with AlP poisoning.
Methods: In this prospective observational study, patients of AlP poisoning admitted at emergency department of Darbhanga Medical college, Bihar from May 2016 to April 2017 were included. On admission, twelve-lead electrocardiogram (ECG) was performed for all patients. All patients underwent continuous cardiac monitoring for whole hospital stay using a cardiac monitor. In patients with suspected arrhythmia on the cardiac monitor, another ECG was obtained immediately.
Results: During the study period, 50 patients with AlP poisoning were treated. Mean age of the patients was 34+/-4.6years ranging from 16 to 64 years. Cardiac arrhythmia was noted in 82%.most frequent arrhythmia was sinus tachycardia (60% of patients) followed by sinus bradycardia (18%)and others. Mortality was 84%. Comparison of death rate between patients with and without cardiac arrhythmia showed a significant difference P < 0.001).
Conclusion: AlP poisoning causes a very high mortality with circulatory collapse as the major cause of death. Early detection of cardiac disorders and proper management of arrhythmias may reduce mortalities.
References
1. 1. Chugh SN. Aluminium phosphide poisoning. Journal of Association of Physician of India 1992; 40 (6): 401-5.
2. Gupta MS, Malik A, Sharma VK. Cardiovascular manifestations in aluminium phosphide poisoning with special reference to echocardiographic changes. Journal of Association of Physician of India 1995; 43 (11): 773- 80.
3. Louriz M, Dendane T, Abidi K, Madani N, Abouqal R, Zeggwagh AA. Prognostic factors of acute aluminum phosphide poisoning. Indian J Med Sci 2009; 63:227-34. 11
4. Mehrpour O, Jafarzadeh M, Abdollahi M. A systematic review of aluminium phosphide poisoning. Arh Hig Rada Toksikol 2012; 63:61-73.
5. Rathore R, Khan MZU. Morbidity, mortality and management of wheat pill poisoning. J Services Inst Med Sci 2007;2:14-8.
6. Singh RB, Rastogi SS, Singh DS. Cardiovascular manifestations of aluminium phosphide poisoning intoxication. Journal of Association of Physician of India 1989; 37(9):590-1.
7. Siwach SB, Singh H, Jagdish, Katyal VK, Bhardwaj G. Cardiac arrhythmias in aluminium phosphide poisoning studied by on continuous holter and cardioscopic monitoring. Journal of Association of Physician of India 1998; 46(7): 598-601.
8. Soltaninejad K, Beyranvand MR, Momenzadeh SA, Shadnia S. Electrocardiographic findings and cardiac manifestations in acute aluminum phosphide poisoning. J Forensic Leg Med 2012;19:291-3.
Abhinandya Mukhopadhyay
Post Graduate Student
Department of General Medicine, DMCH