Open AccessA perfect refractory electrical storm by acute toxicity of accidental aconitine intake
Author(s) -
Francesca Menichetti,
Paola Bartolucci,
Maria Luisa Matteucci,
Luigi Gori,
Alessandra Ieri,
Francesco Gambassi,
Roberto Baronti,
Simone Vanni,
Guido Mannaioni,
Attilio Del Rosso
Publication year - 2021
Publication title -
emergency care journal
Language(s) - English
Resource type - Journals
eISSN - 2282-2054
pISSN - 1826-9826
DOI - 10.4081/ecj.2021.9736
Subject(s) - medicine , ventricular fibrillation , anesthesia , aconitine , sinus bradycardia , bradycardia , ventricular tachycardia , tachycardia , cardiology , heart rate , pharmacology , blood pressure
A 51-years-old male presented with drooling, hematemesis and diarrhea in emergency department after accidental ingestion of homemade aconitine tincture. Examination revealed shock and initial ECG showed atrial fibrillation. The patient suddenly developed a pulseless wide QRS complex tachycardia requiring resuscitation maneuvers. The rhythm varied from monomorphic ventricular tachycardia to torsade de point to ventricular fibrillation. Repeated direct-current cardioversions were unsuccessful. After intravenous electrolyte correction and anti-arrhythmic drugs administration, a last direct-current shock was finally successful. Bradycardia and ventricular excitability persisted over 12 hours with gradual normalization. Patient was discharged in normal sinus rhythm without any medication and on follow-up he was totally asymptomatic.
With the increasing popularity of traditional medicine, clinicians should be alerted to the risk of herbal substances with low margins of safety like Aconitum in order to allow correct diagnosis and treatment. The general public should be educated that herbal medicine is not always safe.