Electrocardiographic findings of methanol toxicity: a cross-sectional study of 356 cases in Iran.
Adolescent
Adult
Aged
Alcoholic Beverages
Atrioventricular Block
/ blood
Betacoronavirus
Blindness
/ blood
Blood Gas Analysis
Brugada Syndrome
/ blood
COVID-19
Consciousness Disorders
/ blood
Coronavirus Infections
Electrocardiography
Female
Food Contamination
Humans
Hydrogen-Ion Concentration
Iran
Long QT Syndrome
/ blood
Male
Methanol
/ poisoning
Middle Aged
Multivariate Analysis
Myocardial Infarction
/ blood
Pandemics
Pneumonia, Viral
Poisoning
/ blood
SARS-CoV-2
Sex Factors
Solvents
/ poisoning
Tachycardia, Sinus
/ blood
Young Adult
ECG
Iran
Methanol toxicity
Myocardial infarction
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
14 09 2020
14 09 2020
Historique:
received:
09
06
2020
accepted:
27
08
2020
entrez:
15
9
2020
pubmed:
16
9
2020
medline:
25
9
2020
Statut:
epublish
Résumé
Methanol is widely used in industry; however, methanol poisoning is not common. In this regard, a number of outbreaks have been recently reported due to inappropriate processing of alcoholic beverages. Shiraz, a city located in the southern part of Iran, faced one of such outbreaks in 2020 during COVID-19 pandemic. There is no sufficient literature on the electrocardiographic findings in methanol toxicity. This study aimed to address this gap in the literature. A total of 356 cases with methanol toxicity referred to Shiraz University of Medical Science Tertiary Hospitals (Faghihi and Namazi) in March and April, 2020. The clinical findings of blindness and impaired level of consciousness, lab data such as arterial blood gas, electrolytes, and creatinine, and the most common findings from ECGs were collected. The most common ECG findings were J point elevation (68.8%), presence of U wave (59.2%), QTc prolongation (53.2% in males and 28.6% in females), and fragmented QRS (33.7%). An outstanding finding in this study was the presence of myocardial infarction in 5.3% of the cases. This finding, to the best of our knowledge, has only been reported in a few case reports. Brugada pattern (8.1%) and Osborn wave (3.7%) were the other interesting findings. In multivariate analysis, when confounding factors were adjusted, myocardial infarction, atrioventricular conduction disturbances, sinus tachycardia, and the prolonged QTC > 500 msecond were four independent factors correlated with methanol toxicity severity measured with arterial blood PH on arterial blood gas measurements, with odds ratios of 12.82, 4.46, 2.32 and 3.15 (P < 0.05 for all), respectively. Electrocardiographic variations during methanol intoxication are remarkable and well-correlated with poisoning severity. Myocardial infarction was an egregious and yet a common concerning finding in this sample, which need to be ruled out in methanol toxicity.
Sections du résumé
BACKGROUND
Methanol is widely used in industry; however, methanol poisoning is not common. In this regard, a number of outbreaks have been recently reported due to inappropriate processing of alcoholic beverages. Shiraz, a city located in the southern part of Iran, faced one of such outbreaks in 2020 during COVID-19 pandemic. There is no sufficient literature on the electrocardiographic findings in methanol toxicity. This study aimed to address this gap in the literature.
METHOD
A total of 356 cases with methanol toxicity referred to Shiraz University of Medical Science Tertiary Hospitals (Faghihi and Namazi) in March and April, 2020. The clinical findings of blindness and impaired level of consciousness, lab data such as arterial blood gas, electrolytes, and creatinine, and the most common findings from ECGs were collected.
RESULTS
The most common ECG findings were J point elevation (68.8%), presence of U wave (59.2%), QTc prolongation (53.2% in males and 28.6% in females), and fragmented QRS (33.7%). An outstanding finding in this study was the presence of myocardial infarction in 5.3% of the cases. This finding, to the best of our knowledge, has only been reported in a few case reports. Brugada pattern (8.1%) and Osborn wave (3.7%) were the other interesting findings. In multivariate analysis, when confounding factors were adjusted, myocardial infarction, atrioventricular conduction disturbances, sinus tachycardia, and the prolonged QTC > 500 msecond were four independent factors correlated with methanol toxicity severity measured with arterial blood PH on arterial blood gas measurements, with odds ratios of 12.82, 4.46, 2.32 and 3.15 (P < 0.05 for all), respectively.
CONCLUSION
Electrocardiographic variations during methanol intoxication are remarkable and well-correlated with poisoning severity. Myocardial infarction was an egregious and yet a common concerning finding in this sample, which need to be ruled out in methanol toxicity.
Identifiants
pubmed: 32928149
doi: 10.1186/s12872-020-01691-y
pii: 10.1186/s12872-020-01691-y
pmc: PMC7488223
doi:
Substances chimiques
Solvents
0
Methanol
Y4S76JWI15
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
415Subventions
Organisme : Vice-Chancellor for Research, Shiraz University of Medical Sciences
ID : 98-01-01-22074
Pays : International
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