Carbon Monoxide Poisoning with Reversible Cardiomyopathy A Case of Accidental Exposure in the Foothills of Himalayas

• Published in: Journal of Cardio-diabetes and Metabolic Disorders Vol. 1; no. 2; pp. 64 - 67
• Main Authors: Agarwal, Mayank, Kant, Ravi, Kalra, Arnav, Dheeraj
• Format: Journal Article
• Language: English
• Published: 01.07.2021
• ISSN: 2772-6819
• DOI: 10.4103/JCDM.JCDM_12_21

Carbon monoxide (CO) can cause intoxication without the victim being aware of it. Its exposure is common in Northern India but is infrequently reported because the clinical features are non-specific. In CO poisoning, myocardial injury is a significant predictor of mortality. We present a case of a middle-aged male, found unconscious inside a closed room on a winter morning. Upon presentation, the patient was drowsy with hypotension. CO oximetry showed carboxyhemoglobin (CO-Hb) of 28.6% and brain imaging, suggestive of hypodensities in bilateral globus pallidus. The patient was managed with high flow oxygen following which his sensorium improved gradually but hypotension persisted with echocardiography showing global left ventricular dysfunction. A session of hyperbaric oxygen therapy was given after which he improved hemodynamically with resolution of cardiac dysfunction over the next 3 days. We highlight the importance of early diagnosis of cardiomyopathy as CO-induced cardiomyopathy may be reversed if timely intervention is done.