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An unusual case of inferior acute myocardial infarction associated with advanced second grade atrio-ventricular block secondary to scombroid — fish poisoning.

  • Case Report
  • Published:
Central European Journal of Medicine

Abstract

Background

Scombroid syndrome (histamine fish poisoning) includes symptoms and signs caused by biogenic amines, mainly due to histamine-containing food.

Methods and results

In this report, we describe a 56 year old female who presented in the clinic with symptoms of scombroid syndrome after the ingestion of tuna fish, then gradually developed cardiovascular shock and inferior ST elevation myocardial infarction (STEMI) associated with advanced second grade atrio-ventricular block at the electrocardiogram (ECG) followed by respiratory arrest. Originally, the patient was treated with intravenous fluid infusion, steroids, ranitidine and chlorpheniramine. Following her cardiovascular shock and respiratory arrest, orotracheal intubation was performed and mechanical ventilation was started immediately. The patient was treated with dobutamine and fluid infusion, which has improved her hemodynamic conditions. Emergency cardiac catheterization was performed one hour after the onset of symptoms and coronary angiography did not show a significant coronary artery disease. The clinical picture has improved during the next days, with complete normalization of the ECG.

Conclusion

Severe symptoms, including myocardial infarction. may occur in cases of scombroid syndrome.

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Authors and Affiliations

  1. Cardiac Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy

    Filippo M. Sarullo, Salvatore Milia & Ylenia Salerno

  2. Division of Cardiology “Paolo Borsellino” G.F Ingrassia Hospital, Palermo, Italy

    Pietro Di Pasquale

  3. Division of Cardiology, Catholic University of Sacred Heart, Rome, Italy

    Antonino Di Franco & Gaetano A. Lanza

Authors
  1. Filippo M. Sarullo
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  2. Antonino Di Franco
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  3. Salvatore Milia
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  4. Ylenia Salerno
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  5. Pietro Di Pasquale
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  6. Gaetano A. Lanza
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Corresponding author

Correspondence to Filippo M. Sarullo.

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Sarullo, F.M., Di Franco, A., Milia, S. et al. An unusual case of inferior acute myocardial infarction associated with advanced second grade atrio-ventricular block secondary to scombroid — fish poisoning.. cent.eur.j.med 8, 586–590 (2013). https://doi.org/10.2478/s11536-013-0169-2

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  • DOI: https://doi.org/10.2478/s11536-013-0169-2

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