Carbon monoxide poisoning can act as a stress test to reveal underlying coronary artery disease: case report

Jinfeng Jiang, Jeffrey S. Cooper

Research output: Contribution to journalArticle

Abstract

Carbon monoxide (CO) poisoning presents with many different cardiac effects, but one important presentation is its effect as a CO stress test to reveal underlying coronary artery disease (CAD). There are a limited number of publications detailing this phenomenon, but after CO intoxication it is important to suspect CAD in association with mild troponin leak or non-ST segment elevation myocardial infarction (NSTEMI) shown on electrocardiogram (EKG). We recently treated three patients with CO poisoning who had underlying CAD. In the first case a man presented to the emergency department with CO toxicity and an ST segment elevation myocardial infarction (STEMI), resulting in emergent angioplasty and the discovery of severe CAD. The second case involved an individual who presented with CO poisoning with rising troponin levels. An angioplasty discovered a stable 90% occlusion. The third case was a patient with CO poisoning and transient inferior T wave inversion EKG with borderline troponin elevation. Angioplasty showed only 30% occlusion, so the patient's presentation was likely due to direct CO cardiac toxicity. These cases demonstrate the varied presentations that CO poisoning can have on patients with underlying heart disease.

Original languageEnglish (US)
Pages (from-to)139-143
Number of pages5
JournalUndersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc
Volume47
Issue number1
StatePublished - Jan 1 2020

Keywords

  • carbon monoxide
  • cardiovascular
  • demand ischemia
  • myocardial infarction
  • stress

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Physiology (medical)

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