Variant angina induced by carbon monoxide Poisoning : A CARE compliant case report

Abstract

Rationale: Carbon monoxide (CO) poisoning can cause severe damage to the nervous system, and can also cause serious damage to organs, such as the heart, kidneys, and lungs. CO damage to myocardial cells has been previously reported. This can lead to serious complications, such as myocardial infarction. Patient concerns: A 47-year-old female patient complained of sudden chest pain for 30minutes. Before admission, the patient had non-radiating burning chest pain after inhalation of soot. Diagnosis: An electrocardiogram showed that myocardial ischemia was progressively aggravated, manifested by progressive STsegment elevation, and accompanied by T wave inversion and other changes. No obvious coronary stenosis was observed in a coronary angiographic examination. Therefore, the patient was considered to have developed variant angina resulting from CO poisoning-induced coronary artery spasm. Interventions: The patient was treated with drugs for improving blood circulation and preventing thrombosis, and underwent hyperbaric oxygen therapy. Outcomes: Clinical symptoms relieved after the treatment. Lessons: Findings from this case suggest that CO can cause coronary artery spasm and it is one of the predisposing factors of variant angina. For these patients, hyperbaric oxygen therapy can improve blood circulation and prevent formation of thrombus and encephalopathy. Abbreviations: BNP = brain natriuretic peptide, CK-MB = creatine kinase-MB, CO = carbon monoxide, COHb = CO hemoglobin, Hb = hemoglobin, MYO = myoglobin, TIMI = myocardial infarction, TNT = Troponin T.