title: Acute toxic herbal intake in a suicide attempt and fatal refractory ventricular arrhythmia.
abstract: This report involves a 54-year-old man who died following refractory ventricular fibrillation after ingestion of a plant in a suicide attempt. Repeated direct-current cardioversions were unsuccessful and no single anti-arrhythmic agent was effective for arrhythmia control. The routine blood toxicological screening was negative. Aconitine, the main toxin of Aconitum napellus was identified using a specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. The whole blood concentration (24 microg/l) was higher than those reported in other aconitine-related deaths. The patient had found information about the life-threatening nature of such a toxic herb intake on a free medical encyclopedia online.
authors.affiliation: Department of Anaesthesiology, Dupuytren Teaching Hospital, Limoges, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Strzelecki
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pichon
authors.forename: Jean M
authors.initials: JM
authors.lastname: Gaulier
authors.forename: Jean B
authors.initials: JB
authors.lastname: Amiel
authors.forename: Pauline
authors.initials: P
authors.lastname: Champy
authors.forename: Marc
authors.initials: M
authors.lastname: Clavel
mesh_terms: D000157:Aconitine / Q000097:blood / Q000737:chemistry / Q000506:poisoning*; D031841:Aconitum / Q000737:chemistry / Q000506:poisoning*; D002851:Chromatography, High Pressure Liquid; D017809:Fatal Outcome; D053593:Forensic Toxicology / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010939:Plant Poisoning / Q000209:etiology; D028321:Plant Preparations / Q000737:chemistry / Q000506:poisoning; D010947:Plants, Toxic / Q000737:chemistry / Q000506:poisoning*; D013405:Suicide; D053719:Tandem Mass Spectrometry; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D028321:Plant Preparations; D000157:Aconitine