Grayanotoxın Blocked Both The Av Node And The Accessory Pathway


Atıcı A.

29. Turkish Cardiology Congress with International Participation, Antalya, Türkiye, 26 - 29 Ekim 2013, cilt.034, no.2138, ss.1-2

  • Cilt numarası: 034
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayısı: ss.1-2

Özet

A MAN, AGED 60, ADMITTED TO EMERGENCY BECAUSE OF DIZZINESS AND ASTHENIA. THE MAN HAD DIZZY SPELL AND ASTHENIA 4 HOURS BEFORE APPLYING TO THE EMERGENCY. IT IS KNOWN THAT THE PATIENT HAD EATEN 4 OR 5 SOUP SPOONS OF HONEY, WHICH HAD BEEN PRODUCED IN EAST BLACKSEA REGION, 3 HOURS BEFORE HIS COMPLAINTS STARTED. IN HIS PHYSICAL EXAMINATION; BLOOD PRESSURE: 87/44 MMHG, HEART RATE: 39/MIN, RESPIRATION RATE: 16/MIN, PERIPHERAL FEVER: 36.8 °C AND NOTHING DETECTED IN OTHER SYSTEM EXAMINATION.
THE HEMOGRAM AND THE BIOCHEMISTRY OF THE PATIENT WERE NORMAL. IN THE ELECTROCARDIOGRAPHY (ECG) THE PATIENT WAS IN AV COMPLETE BLOCK RHYTHM (SEE PICTURE 1). THE HEART RATE WAS 37/MIN. OUR DIAGNOSIS WAS MAD HONEY POISONING. IN THE CONTROL ECG, THE RHYTHM WAS 2:1 INHERITED AV BLOCK (SEE PICTURE 2). QRS COMPLEX WHICH COMES AFTER P WAVE, WAS NARROW, PR DISTANCE WAS SHORT AND DELTA WAVE WAS RECOGNIZED. THE HEMODYNAMICS OF THE PATIENT WAS STABLE. THE PATIENT WAS MONITORIZED AND 24 HOURS LATER THE PATIENT WAS IN SINUS RHYTHM WITH TYPICAL WPW PATTERN. (SEE PICTURE 3). THE PATIENT WAS EXTERNED WITHOUT MEDICATION DUE TO THE FACT THAT HIS COMPLAINTS WERE FINISHED.
INCREASE IN THE DEGREE OF PREEXCICATION UNDER THE ACCESSORY PATHWAY WHICH HAS ANTEGRADE CONDUCTION CAPABILITY CAN BE SEEN WHEN THE DEPRESSION CHARACTERISTICS OF GYRANOTOXIN’S ON AV NODE IS CONSIDERED. ON THE CONTRARY, WITH THE EFFECT OF GRAYANOTOXIN BOTH THE AV NODE AND ACCESSORY PATHWAY WERE 2:1 INHERITED BLOCKED. IT IS ARGUABLE THAT THE ABOVE DESCRIBED SITUATION ABOUT GRAYANOTOXIN, IN WHICH THE GRAYANOTOXIN BLOCKS THE ACCESSORY PATHWAY WHICH DOESN’T HAVE DECRIMENTAL CONDUCTION CAPABILITY, IS NOT KNOWN IN LITERATURE