title: Aconite poisoning with arrhythmia and shock.
abstract: A 55-year-old male presented with history of nausea, vomiting, palpitation paresthesis and profuse sweating in emergency department 2h after ingestion of "Bachnaag" (Aconite) root. Examination revealed shock with irregular pulses. Initial ECG showed frequent multifocal ventricular ectopics (VE), which later turned to short runs of ventricular tachycardia (VT). Immediate gastric lavage was done and activated charcoal given. Patient was treated with fluid resuscitation without any improvement in blood pressure. Patient was started on nor-adrenaline infusion with gradual recovery from hypotension over a period of 6h, but support was continued for 48h. Amiodarone was started to control ventricular excitability, which persisted over 72h with gradual decrease in frequency of VT and VE. Patient was discharged with normal sinus rhythm on oral amiodarone on 5th day of hospitalization. On follow-up after 2 weeks patient was totally asymptomatic and amiodarone was stopped.
authors.affiliation: Asso. Professor of Medicine, Dr. S.N. Medical College, Jodhpur, India. Electronic address: drstak@yahoo.com.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Tak
authors.affiliation: Professor of Medicine, Dr. S.N. Medical College, Jodhpur, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Lakhotia
authors.affiliation: Professor of Medicine, Dr. S.N. Medical College, Jodhpur, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Assistant Professor of Medicine, Dr. S.N. Medical College, Jodhpur, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Sagar
authors.affiliation: Assistant Professor of Medicine, Dr. S.N. Medical College, Jodhpur, India.
authors.forename: Gopal
authors.initials: G
authors.lastname: Bohra
authors.affiliation: Resident, Department of Medicine, Dr. S.N. Medical College, Jodhpur, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Bajari
mesh_terms: D031841:Aconitum / Q000506:poisoning*; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D004562:Electrocardiography; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018517:Plant Roots / Q000506:poisoning; D012769:Shock / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone
keywords: Aconite; Amiodarone; Arrhythmia; Cardiotoxicity; Shock