Prognostic Study of Aluminium Phosphide Ingestion Patients and Their Correlation with Cardiac Manifestations On The Basis of ECG Abnormality

Abstract

Introduction: Mortality due to Aluminium phosphide ALP ingestion is very high (37-100%) and is directly related to freshness of tablet, dose of pesticide consumed and delay in institution of treatment etc. Death is mainly due to cardio toxicity, development of ARDS, non-responsiveness of shock to resuscitative measures, lack of an antidote and subsequent development of complications like acute massive GI bleed, acute respiratory arrest, acute CHF, DIC etc. Aim & Objective: To Study the ‘Clinico investigatory’ findings in Aluminium phosphide ALP poisoning. Assessment and correlation of ECG findings with the survival of these patients. Methodology: Patients of age group > 18 years and both sexes, who fulfilled criteria of patient's selection, will be taken into consideration. Results: Majority of victims were young patients in struggling phase of life as study, career and family matters between age range of 14-30 years and males & females ratio was 1.9:1 predominantly males.Majority of patients consumed one exposed tablets of Aluminium phosphide poisoning. Shock was the cardinal manifestation in majority of the patients. Tachycardia, cold clammy skin, mid pupillary dilatation with sluggish pupillary reaction and chest crepitations were the next common physical signs. Various ECG abnormalities recorded on the third day were the sinus tachycardia (10/77), non specific ST-T changes (00), low voltage complex (10/77) and RBBB in 06/77 cases. Conclusion: Thus, it can be concluded from the present study that Aluminium phosphide is cardiotoxic in 100% cases as evident from various changes in ECG recording an ECHO confirmed this and evident of focal carditis and wet pericarditis was evident. It is further stipulated that toxicity of conduction system of heart are more prominent than the myocardium.