Cardiotoxicity in Pediatric Carbon Monoxide Poisoning: A Case Report

Carbon monoxide poisoning and its sequelae have been well described in the literature. It is a relatively common environmental toxin seen in both accidental and intentional poisonings. The organs most affected are those most dependent upon oxygen for their function. Most notable of these are the brain and the heart. The cardiac manifestations described in the literature range from severe cardiac failure with cardiogenic shock to ischemic changes detected by electrocardiogram and/or by enzyme and troponin measurement. The following is a case describing clinically severe carbon monoxide toxicity in a 14-year-old female adolescent who exhibited neurological symptoms as well as cardiac ischemia in the setting of a low initial carboxyhemoglobin level. The pathophysiology of carbon monoxide poisoning of the heart is also discussed.