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JACC-Heart Fail., Feb 09 2024, S2213-1779(24)00051-9 | https://doi.org/10.1016/j.jchf.2024.01.001 Practical Recommendations for the Evaluation and Management of Cardiac Injury Due to Carbon Monoxide Poisoning

Dong-Hyuk Cho MD, PhD ^a∗, Stephen R. Thom MD, PhD ^b∗, Jung-Woo Son MD ^c, Sung Min Ko MD, PhD ^d, Yong Sung Cha MD, PhD ^e,f

^aDivision of Cardiology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea

^bDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA

^cDivision of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

^dDepartment of Radiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

^eDepartment of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

^fResearch Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

Address for correspondence: Dr Yong Sung Cha

Abstract

Carbon monoxide (CO) is a relatively frequent cause of poisoning evaluated in emergency departments. The risk of neurologic injuries, such as cognitive, psychological, vestibular, and motor deficits, is 25% to 50%. However, the risk of cardiac injuries should also be considered. Among patients with CO poisoning, the mortality in patients with myocardial injury is approximately 3 times greater than that in patients without myocardial injury. In large-scale studies, up to 69.2% of patients with acute CO poisoning exhibiting elevated troponin I levels and no underlying cardiovascular illnesses had late gadolinium enhancement on cardiac magnetic resonance, suggesting covert CO-induced myocardial fibrosis. Myocardial damage can be evaluated using electrocardiography, echocardiography, computed tomography, and cardiac magnetic resonance. This paper offers recommendations for cardiac evaluations based on our collective experience of managing >2,000 cases of acute CO poisoning with supporting information taken from peer-reviewed published reports on CO poisoning.

논문정보

형식Review Paper
게재일2024년 02월 (BRIC 등록일 2024-02-23)
연구진국내(교신)+국외 연구진
분야 의약학 > 응용의학

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