Carbon Monoxide Poisoning Induces Myocardial Injury With ECG ST Elevation: A Case Report and Literature Review

Pei-Yi Shen；Po-Hsin Lee；Tsai-Yun Lee；Yi-Wen Chen；Chun-Shih Chin

Carbon monoxide poisoning ； CO poisoning-related cardiac injury ； myocardial injury ； myocardial injury with ST elevation

胸腔醫學

39卷3期（2024 / 09 / 01）

275 - 280

英文

In patients with carbon monoxide (CO) poisoning, tailored evaluation is needed due to the high likelihood of symptoms overlapping with myocardial infarction. Here, we reported a 58-year-old man who presented to the emergency room after smoke inhalation. His complaints were shortness of breath, hoarseness, sore throat, dizziness, and general weakness. Laboratory results showed elevated cardiac enzymes, metabolic acidosis and elevated serum carboxyhemoglobin. CO poisoning was diagnosed accordingly. Electrocardiography (ECG) revealed atypical territories involvement with II, III, aVF, and V2-V5 ST elevation. His coronary angiography, however, showed patent coronary arteries. It is difficult to distinguish myocardial injury caused by CO poisoning from true acute myocardial infarction. Ischemic patterns in atypical territories on an ECG can offer a crucial clue in this differentiation. However, angiography and revascularization should still be considered in patients with highly suspected acute myocardial infarction.