title: Carbon monoxide poisoning-induced cardiomyopathy from charcoal at a barbecue restaurant: a case report.
abstract: OBJECTIVE
  Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker.
  
  
  METHODS
  A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications.
  
  
  RESULTS
  Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient's medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours.
  
  
  CONCLUSIONS
  Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Yun Kyung
authors.initials: YK
authors.lastname: Chung
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Kyeong Min
authors.initials: KM
authors.lastname: Kwak
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Se-Jin
authors.initials: SJ
authors.lastname: Ahn
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Yong-Hyun
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Young-Su
authors.initials: YS
authors.lastname: Ju
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang City, Republic of Korea.
authors.forename: Young-Jun
authors.initials: YJ
authors.lastname: Kwon
authors.affiliation: Center for Occupational Health Research, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan City, Republic of Korea.
authors.forename: Eun-A
authors.initials: EA
authors.lastname: Kim
keywords: Carbon monoxide poisoning; Cardiomyopathy; Charcoal; Restaurant worker