CERBERA ODOLLAM POISONING- ECG AND CARDIAC CHANGES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 1
Abstract
BACKGROUND Cerbera odollam is a common vegetable suicidal agent in Kerala, where its incidence is next to the insecticidal group of poisons. The most important toxic principle acting on the cardiovascular system is cerberin. The toxins act on the cardiovascular system by two entirely different ways: 1) Haemorrhage in the conducting tissue of heart: SA node, AV node, AV bundle or bundle branches causing alterations in the impulse production and conduction and 2) Hyperkalaemia- ECG changes/ Dysrhythmias. The structural changes in the conducting tissue of heart and the electrolyte changes in the serum, either alone or in combination cause many ECG changes, precipitating a ‘heart attack.’ Suicidal Cerbera Odollam poisoning is seen only in South Kerala, nowhere else in the world. It is a cardiac poison producing ‘Heart attack’ and sudden death. Yet detailed studies- both ECG in clinical cases and Conducting Tissue of Heart in autopsy cases- are limited. Hence, the present study is undertaken. MATERIALS AND METHODS 1. ECG changes recorded in 20 reliable cases of Cerbera odollam poisoning treated. 2. Histopathological changes in cardiac tissue in 20 reliable cases autopsied. RESULTS 1. ECG changes, variable in nature, were noted in all the 20 cases. 2. Haemorrhage was noted in 80% of cases in the conducting tissue of the heart- SA node, AV node, AV bundle or bundle branches. CONCLUSION Cerbera odollam is a common suicidal agent confined to the Southern Kerala. Death is due to ‘heart attack’ precipitated by the ECG changes produced by hyperkalaemia or structural changes in the heart, either alone or in combination.
Authors and Affiliations
Sankaran Mohandas
Keywords
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- EP ID EP284498
- DOI 10.14260/jemds/2018/24
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