Nida Sajid, Faiza Ghuman, Sadia Iqbal, Qamar Un Nisa, Sadaf Ahmed Asim, Ayesha Sarwat, Afzal Qasim, Rabia Azmat, Noor-us Saba.
Acute Organophosphate Poisoning; Electrocardiographic Manifestations.
Professional Med J Jan ;24(10):1461-5.

Introduction: Organophosphate poisoning (OP) is a serious public health problem. Cardiac manifestations are seen in majority of patients with OP and may range from sinus tachycardia to more serious ventricular tachyarrhythmias. Objectives: To determine the electrocardiographical manifestations of acute organophosphate poisoning at a tertiary care hospital. Study Design: Observational study. Setting: Department of Medicine, Abbasi Shaheed Hospital, Karachi. Period: February 2011 to August 2011 over a period of six months. Patients and methods: All patients of either sex presenting with the history or evidence of exposure to organophosphorus compounds within 24 hours with characteristics manifestations of organophosphate poisoning were included in the study. Electrocardiographic manifestations were observed before the institution of medical therapy. Results: A total of 123 patients, 81 (65.9%) male and 42 (34.1%) female were included in the study. The Mean (+SD) age of the study participants was 29.07 (+ 9.61) years. Majority (74%) patients had age <35 years and 78 (63.4%) patients in this study had time duration of <6 hours between ingestion of organophosphorus and institution of therapy. The overall electrocardiographic changes were observed in 86.2% of patients. Out of these, ST elevation was seen in 19.8%, T-wave inversion in 17.9%, prolonged PR interval in 9.4%, atrial fibrillation in 6.6% and prolonged QTc interval seen in 46.2%. Conclusion: Electrocardiographical changes are common manifestation of acute organophosphate poisoning. Prolonged QTc interval and ST segment elevation are the most common finding in our patients. As these changes in ECG can lead to serious consequences, therefore it should be carefully evaluated in every patient with OP so that early intervention can be done.

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