Subclinical chronic left ventricular systolic dysfunction resulting from phosphine poisoning.

Occupational medicine (Oxford, England) Pub Date : 2017-04-01 Epub Date: 2017-02-21 DOI:10.1093/occmed/kqx005
E Szymczyk, M Wiszniewska, J Walusiak-Skorupa, J D Kasprzak, P Lipiec
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引用次数: 3

Abstract

We present a case of a 32-year-old male crew member of a cargo ship, accidentally exposed to phosphine, a fumigating substance. He and other crew members developed increasing fatigue and digestive disorders 24 h later; two died from acute pulmonary oedema. The patient was admitted to hospital, where bilateral pneumonia, acute nephritis, hepatopathy, electrolyte imbalance and leucopenia were diagnosed. He was discharged from hospital 3 weeks later. He was examined 4 months later for possible chronic consequences of acute phosphine poisoning, which included echocardiography showing normal heart size and cardiac function. However, on advanced quantitative analysis, using two-dimensional speckle tracking echocardiography, depressed global longitudinal strain was found. Our report extends previously published findings of phosphine-induced left ventricular (LV) dysfunction by demonstrating that subclinical myocardial dysfunction resulting from acute phosphine exposure may persist several months after the exposure in an otherwise asymptomatic patient, and potentially may not be entirely reversible. The persistence of subclinical abnormalities of LV longitudinal function can be diagnosed using the advanced quantitative echocardiographic analysis we describe.

膦中毒引起的亚临床慢性左室收缩功能不全。
我们报告一个32岁的货船男性船员,意外暴露于磷化氢,一种熏蒸物质。24小时后,他和其他机组人员出现了越来越严重的疲劳和消化系统紊乱;其中两人死于急性肺水肿。患者入院,诊断为双侧肺炎、急性肾炎、肝病、电解质失衡和白细胞减少。3周后他出院了。4个月后检查急性磷化氢中毒可能的慢性后果,包括超声心动图显示心脏大小和心功能正常。然而,在先进的定量分析中,使用二维散斑跟踪超声心动图,发现整体纵向应变下降。我们的报告扩展了先前发表的关于磷化氢诱导左心室功能障碍的研究结果,证明急性磷化氢暴露导致的亚临床心肌功能障碍可能在无症状患者暴露后持续数月,并且可能不完全可逆。持续的亚临床异常的左室纵向功能可以诊断使用先进的定量超声心动图分析我们描述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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