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Journal of The Korean Society of Emergency Medicine 1995;6(1): 154-161. |
| A CLINICAL STUDY OF ACONITINE POISONING |
| Jun Hee Lee, Kyung Rae Kim |
| Department of Emergency medicine, Inha University College Medicine |
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Published online: June 30, 1995. |
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| ABSTRACT |
Background
In Korea, the roots of Aconitum species had long been prescibed in the herb medicine, but is still used sometimes as a folk remedy for the purpose of analgesics, antiinflammatory, or cardiotonics, resulting in serious intoxication due to its low safety margin.
Study objectives : This study was conducted to document the adverse effects related aconitine and to determine the outcome in these patients.
Study objectives : This study was conducted to document the adverse effects related aconitine and to determine the outcome in these patients.
Study Subject : A retrospective survey was conducted of 12 patients admitted to the Inha hospital with a history of acute aconitine poisoning over a five year period from 1990 to 1994.
Results
: All patients represented very similar features. The symptoms were general weak ness(11 patients), tingling & numbness of mouth and/or extremities(10 patients), nausea and vomiting(9 patients), dizziness(9 patients), dyspea(8 patients), palpitation(8 patients), chest discomfort(7 patients), epigastric pain(5 patients) and syncope(1 patients) in order of frequency. All patients developed symptoms of aconitine toxicity within 2 hours of ingestion.
The reasons for taking aconitine were neuralgia(9 patients), cerebrovascular accident(2 patients), and accidental (1 patient). All patient showed cardiac arrhythmias. The arryhthmias were ventricular premature beat( 10 patients), atrial premature beat(6 patients), paroxysmal atrial tachycardia(2 patients), first degree A-V block(3 patients), A-V dissociation(2 patients), atrial fibrillation(l patient), ventricular tachycardial(1 patient), nonsustained ventricu lar tachycardia(l patient), complete RBBB(1 patient), and incomplete LBBB(1 patient). The arrhythmias were coverted to normal sinus rhythm in all 10 admitted patients until discharge. Eight patient represented hypotension. But with conservative management, all patients were recovered from hypotension. There was no fatal case, but one patient was identified with feature of myocardial ischemia as a sequale.
conclusion : Aconitum species can cause cardiovascular collapse and serious ventricular arrhythmias. In-hospital observation with ECG monitioring and supportive management should be done until the patient shows normal sinus rhythm and stable blood pressure. the medical profession and general public should be alerted to the potential toxicity of these herbs and their usage should be controlled by regislation.
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| Key words:
Aconitine poisoning, Cardiac arrhythmia |
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