Two cases of chlorinated hydrocarbon-associated myocardial ischemia.
Chlorinated hydrocarbons are well known to produce ventricular arrhythmias because of myocardial sensitization to endogenous catecholamines, but cases of myocardial ischemia have not been described frequently. We report 2 cases of myocardial ischemia after exposure to chlorinated hydrocarbons. The first patient developed an asymptomatic myocardial infarction after inhalation of 1,1,1-trichloroethane at work. It is believed that 1,1,1-trichloroethane produced a coronary spasm that was sufficient to cause myocardial necrosis in the presence of coronary vessels already compromised by atherosclerosis. The second patient developed a reversible symptomatic myocardial ischemia of 4 h duration after chloral hydrate overdose. The evolution in both patients was favorable. Exposure to chlorinated hydrocarbons can be associated with myocardial ischemia particularly if the coronary circulation is already compromised.
Bailey
B
B
Department of Pediatrics, Hospital for Sick Children, Toronto, Canada.
Loebstein
R
R
Lai
C
C
McGuigan
M A
MA
D000328:Adult; D002697:Chloral Hydrate / Q000009:adverse effects*; D003327:Coronary Disease / Q000150:complications; D062787:Drug Overdose; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000139:chemically induced*; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000175:diagnosis; D016273:Occupational Exposure / Q000009:adverse effects*; D012997:Solvents / Q000009:adverse effects*; D013406:Suicide, Attempted; D014240:Trichloroethanes / Q000009:adverse effects*
D006993:Hypnotics and Sedatives; D012997:Solvents; D014240:Trichloroethanes; C024566:1,1,1-trichloroethane; D002697:Chloral Hydrate