title: Herb-induced cardiotoxicity from accidental aconitine overdose.
abstract: Patients who overdose on aconite can present with life-threatening ventricular arrhythmia. Aconite must be prepared and used with caution to avoid cardiotoxic effects that can be fatal. We herein describe a case of a patient who had an accidental aconite overdose but survived with no lasting effects. The patient had prepared Chinese herbal medication to treat his pain, which resulted in an accidental overdose of aconite with cardiotoxic and neurotoxic effects. The patient had ventricular tachycardia, bidirectional ventricular tachycardia and ventricular fibrillation. Following treatment with anti-arrhythmic medications, defibrillation and cardiopulmonary resuscitation, he made an uneventful recovery, with no further cardiac arrhythmias reported.
authors.affiliation: Accident and Emergency Department, Changi General Hospital, Singapore.
authors.forename: Sujata
authors.initials: S
authors.lastname: Sheth
authors.affiliation: Accident and Emergency Department, Changi General Hospital, Singapore.
authors.forename: Elaine Ching Ching
authors.initials: EC
authors.lastname: Tan
authors.affiliation: Clinical Toxicology Consultation Service, Accident and Emergency Department, Changi General Hospital, Singapore.
authors.forename: Hock Heng
authors.initials: HH
authors.lastname: Tan
authors.affiliation: Cardiology Department, Changi General Hospital, Singapore.
authors.forename: Leslie
authors.initials: L
authors.lastname: Tay
mesh_terms: D000157:Aconitine / Q000506:poisoning*; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation; D066126:Cardiotoxicity; D062787:Drug Overdose; D004365:Drugs, Chinese Herbal / Q000506:poisoning*; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D008297:Male; D013610:Tachycardia / Q000139:chemically induced; D017180:Tachycardia, Ventricular / Q000139:chemically induced; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000139:chemically induced
chemical_list: D000889:Anti-Arrhythmia Agents; D004365:Drugs, Chinese Herbal; D000157:Aconitine
keywords: aconite; aconitine herb; bidirectional ventricular tachycardia; cardiotoxic; overdose