Prolonged cardiotoxicity from poison lilly (Veratrum viride).
A 51-y-o otherwise healthy male presented to the emergency department 45 min after ingesting a soup made with boiled "leeks". Physical examination was significant for severe vomiting depressed mental status, and sluggishly reactive 2-3 mm pupils. Heart rate was 30 bpm and bp was 40/p mmHg requiring atropine and fluid resuscitation. After 60 min substernal chest pressure was noted and an ECG showed new V2-V6 ST segment depression. Recurrent hypotension required the use ofa dopamine infusion. At this time, the regional poison control center botanist identified a sample of the ingested material as Veratrum viride. The patient improved slowly over the next 24 hours, although bradycardia and heart block persisted for approximately 48 hours.
Prince
L A
LA
Department of Emergency Medicine, Upstate Medical University, Syracuse, NY 13210, USA.
Stork
C M
CM
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001285:Atropine / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D004562:Electrocardiography; D006331:Heart Diseases / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010946:Plants, Medicinal; D010947:Plants, Toxic; D016896:Treatment Outcome; D014703:Veratrum; D014704:Veratrum Alkaloids / Q000506:poisoning*
D000959:Antihypertensive Agents; D014704:Veratrum Alkaloids; D001285:Atropine; D004298:Dopamine