Skip to main content
SpringerLink
Log in

Effects of Acute Carbon Monoxide Poisoning on ECG and Echocardiographic Parameters in Children

  • Published:
Cardiovascular Toxicology Aims and scope Submit manuscript

Abstract

The aim of the current study is to investigate the effects of CO (carbon monoxide) on the cardiovascular system via electrocardiographic, echocardiographic and biochemical findings in children. This prospective study included 22 children with CO poisoning and 24 healthy children as a control group. The CO-intoxicated children were evaluated via electrocardiography and echocardiography 1 h after admission to the emergency department and daily until their discharge from the hospital. Blood gasses, complete blood account, troponin I and creatinine kinase-MB(CK-MB) were assessed daily. Tpeak–end (p:0.001), QTc durations (p:0.02), Tpeak–end dispersion (p:0.001) and Tpeak–end/QT ratio (p:0.001) of CO-intoxicated patients were significantly higher than those in the control group. Mitral E duration (p:0.001), mitral E/A ratio (p:0.001) and left ventricle contractile fraction (p:0.023) at admission were significantly lower, and left ventricle myocardial performance index was higher (p:0.001) in the CO poisoning group. Troponin I and CK-MB levels were higher at admission in 6 (27 %) and 4 (18 %) patients, respectively. The heart is the most critical organ in pediatric CO poisoning. These children present subclinical systolic and diastolic left ventricle dysfunction even in mild cases. Although, in children with acute CO-intoxication ventricular repolarization is impaired, it seems to be reversible like other findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Cha, Y. S., Cha, K. C., Kim, O. H., Lee, K. H., Hwang, S. O., & Kim, H. (2014). Features and predictors of myocardial injury in carbon monoxide poisoned patients. Emergency Medical Journal, 31(3), 210–215.

    Article  Google Scholar 

  2. Cobb, N., & Etzel, R. A. (1991). Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988. JAMA, 266(5), 659–663.

    Article  CAS  PubMed  Google Scholar 

  3. Aslan, S., Uzkeser, M., Seven, B., Gundogdu, F., Acemoglu, H., Aksakal, E., et al. (2006). The evaluation of myocardial damage in 83 young adults with carbon monoxide poisoning in the East Anatolia region in Turkey. Human and Experimental Toxicology, 25(8), 439–446.

    Article  CAS  PubMed  Google Scholar 

  4. Lee, D., Hsu, T. L., Chen, C. H., Wang, S. P., & Chang, M. S. (1996). Myocardial infarction with normal coronary artery after carbon monoxide exposure: A case report. Zhonghua Yi Xue Za Zhi (Taipei), 57(5), 355–359.

    CAS  Google Scholar 

  5. Satran, D., Henry, C. R., Adkinson, C., Nicholson, C. I., Bracha, Y., & Henry, T. D. (2005). Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. Journal of the American College of Cardiology, 45(9), 1513–1516.

    Article  CAS  PubMed  Google Scholar 

  6. Kalay, N., Ozdogru, I., Cetinkaya, Y., Eryol, N. K., Dogan, A., Gul, I., et al. (2007). Cardiovascular effects of carbon monoxide poisoning. American Journal of Cardiology, 99(3), 322–324.

    Article  CAS  PubMed  Google Scholar 

  7. Eroglu, M., Uz, O., Isilak, Z., Yalcin, M., Yildirim, A. O., & Kardesoglu, E. (2014). Carbon monoxide poisoning increases Tpeak-Tend dispersion and QTc dispersion. Cardiovascular Journal of Africa, 25(3), 106–109.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ciftçi, O., Günday, M., Calışkan, M., Güllü, H., Doğan, R., Güven, A., et al. (2013). Mild carbon monoxide poisoning impairs left ventricular diastolic function. Indian Journal of Critical Care Medicine, 17(3), 148–153.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Park, J. S., Seo, K. W., Choi, B. J., Choi, S. Y., Yoon, M. H., Hwang, G. S., Tahk, S. J., Choi, S. C., Min, Y. G, & Shin, J. H. (2015). Various echocardiographic patterns of left ventricular systolic dysfunction induced by carbon monoxide intoxication. Cardiovascular Toxicology, Oct 26. [Epub ahead of print].

  10. Hancı, V., Ayoğlu, H., Yurtlu, S., Yıldırım, N., Okyay, D., Erdoğan, G., et al. (2011). Effects of acute carbonmonoxide poisoning on the P-wave and QT interval dispersions. Anadolu Kardiyol Derg, 11(1), 48–52.

    PubMed  Google Scholar 

  11. Yelken, B., Tanriverdi, B., Cetinbaş, F., Memiş, D., & Süt, N. (2009). The assessment of QT intervals in acute carbonmonoxide poisoning. Anadolu Kardiyol Derg, 9(5), 397–400.

    PubMed  Google Scholar 

  12. Dragelytė, G., Plenta, J., Chmieliauskas, S., Jasulaitis, A., Raudys, R., Jovaiša, T., & Badaras, R. (2014). Myocardial rupture following carbon monoxide poisoning. Case Reports in Critical Care, [Epub 2014 Jul 9].

  13. Teksam, O., Gumus, P., Bayrakci, B., Erdogan, I., & Kale, G. (2010). Acute cardiac effects of carbon monoxide poisoning in children. European Journal of Emergency Medicine, 17(4), 192–196.

    Article  PubMed  Google Scholar 

  14. Akilli, N. B., Akinci, E., Akilli, H., Dundar, Z. D., Koylu, R., Polat, M., et al. (2013). A new marker for myocardial injury in carbon monoxide poisoning: T peak-T end. American Journal of Emergency Medicine, 31(12), 1651–1655.

    Article  PubMed  Google Scholar 

  15. Castro Hevia, J., Antzelevitch, C., TornesBarzaga, F., Dorantes Sanchez, M., Dorticos Balea, F., Zayas Molina, R., et al. (2006). Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. Journal of the American College of Cardiology, 47, 1828–1834.

    Article  PubMed  Google Scholar 

  16. Hlaing, T., Guo, D., Zhao, X., DiMino, T., Greenspon, L., Kowey, P. R., et al. (2005). QT and Tp-e intervals in left and right chest leads: comparison between patients with systemic and pulmonary hypertension. Journal of Electrocardiology, 38, 154–158.

    Article  PubMed  Google Scholar 

  17. Alam, M., Wardell, J., Andersson, E., Samad, B. A., & Nordlander, R. (1999). Characteristics of mitral and tricuspid annular velocities determined by pulsed wave Doppler tissue imaging in healthy subjects. Journal of the American Society of Echocardiography, 12, 618–628.

    Article  CAS  PubMed  Google Scholar 

  18. Gupta, P., Patel, C., Patel, H., Narayanaswamy, S., Malhotra, B., Green, J. T., et al. (2008). T(p-e)/QT ratio as an index of arrhythmogenesis. Journal of Electrocardiology, 41, 567–574.

    Article  PubMed  Google Scholar 

  19. Karakaya, O., Barutcu, I., Esen, A. M., Kaya, D., Turkmen, M., Melek, M., et al. (2006). Acute smoking induced alterations in Doppler echocardiographic measurements in chronic smokers. Texas Heart Institute Journal, 33, 134–138.

    PubMed  PubMed Central  Google Scholar 

  20. Tei, C., Nishimura, R. A., Seward, J. B., & Tajik, A. J. (1997). Noninvasive Doppler derived myocardial performance index: Correlation with simultaneous measurements of cardiac catheterization measurements. Journal of the American Society of Echocardiography, 10, 169–178.

    Article  CAS  PubMed  Google Scholar 

  21. Gurkan, Y., Canatay, H., Toprak, A., Ural, E., & Toker, K. (2002). Carbon monoxide poisoning: A cause of increased QT dispersion. Acta Anaesthesiologica Scandinavica, 46, 180–183.

    Article  CAS  PubMed  Google Scholar 

  22. Mozos, I., & Serban, C. (2011). The relation between QT interval and T-wave variables in hypertensive patients. Journal of Pharmacy and Bioallied Sciences, 3, 339–344.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Poulsen, S. H., Jensen, S. E., Tei, C., Seward, J. B., & Egstrup, K. (2000). Value of the Doppler index of myocardial performance in the early phase of acute myocardial infarction. Journal of the American Society of Echocardiography, 13, 723–730.

    Article  CAS  PubMed  Google Scholar 

  24. Blauwet, L. A., & Cooper, L. T. (2010). Myocarditis. Progress in Cardiovascular Diseases, 52(4), 274–288.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology, Ministry of Health, Mersin Woman’s and Children’s Hospital, 33240, Toroslar-Mersin, Turkey

    Abdullah Ozyurt & Ayse Esin Kibar

  2. Department of Pediatric Cardiology, Mersin University School of Medicine, Mersin, Turkey

    Derya Karpuz & Olgu Hallioglu

  3. Department of Pediatrics, Ministry of Health, Mersin Woman’s and Children’s Hospital, Mersin, Turkey

    Aydin Yucel & Mehtap Durukan Tosun

Authors
  1. Abdullah Ozyurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Derya Karpuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aydin Yucel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehtap Durukan Tosun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayse Esin Kibar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Olgu Hallioglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abdullah Ozyurt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ozyurt, A., Karpuz, D., Yucel, A. et al. Effects of Acute Carbon Monoxide Poisoning on ECG and Echocardiographic Parameters in Children. Cardiovasc Toxicol 17, 326–334 (2017). https://doi.org/10.1007/s12012-016-9389-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12012-016-9389-4

Keywords

Search

Navigation