Electrocardiogram Changes in Patients With Acute Ethanol Poisoning
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 11 No. 2 (2021),
15 June 2021
,
Page 33353
https://doi.org/10.32598/ijmtfm.v11i2.33353
Abstract
Background: Alcohol consumption leads to a significant number of deaths, mostly in men, worldwide. Considering the effect of ethanol toxicity on the heart, we studied various Electrocardiographic (ECG) changes in patients with acute ethanol poisoning.
Methods: A cross-sectional study was performed on patients admitted to Khorshid Hospital (affiliated to Isfahan University of Medical Sciences) due to ethanol poisoning. All 15- to 50-year-old patients with acute ethanol intoxication were included in the study (N=250). The patients’ information, including the demographic characteristics, clinical manifestations, and ECG changes were recorded and analyzed. Different variables were compared between the patients with or without ECG changes.
Results: Most of the research patients (n=208) were men (83.82%). The Mean±SD age of the study patients was 26.8±8.87 years. About 54.8% of the patients presented abnormal ECG. The changes in ECG were not significantly different based on the demographic characteristic and clinical manifestations. The time interval between ethanol consumption and admission was significantly higher in patients with abnormal ECG, compared to those with normal ECG (Mean±SD: 7.09±10.67 vs. 4.77± 4.54 hours, respectively) (P=0.03).
Conclusion: ECG changes are common in patients with ethanol poisoning. The time interval between ethanol consumption to hospital admission may be an important factor in the occurrence of ECG changes.
- Poisoning, Ethyl alcohol, Electrocardiogram (ECG), Arrhythmia
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References
1. http://www.who.int/substance-abuse/publications/global-alcohol-report/en/
2. Alinejad S, Zamani N, Abdollahi M, Mehrpour O. A Narrative Review of Acute Adult Poisoning in Iran. Iran J Med Sci. 2017;42(4):327-346.
3. Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Goldfrank’s Toxicologic Emergencies. 11th Ed. New York: McGraw-Hill Companies; 2019. P. 1146-9.
4. George A, Figueredo VM. Alcohol and arrhythmias: a comprehensive review. Journal of cardiovascular medicine. 2010;11(4):221-8.
5. Djoussé L, Levy D, Benjamin EJ, Blease SJ, Russ A, Larson MG, et al. Long-term alcohol consumption and the risk of atrial fibrillation in the Framingham Study. The American journal of cardiology. 2004;93(6):710-3.
6. Kupari M, Koskinen P, Suokas A. Left ventricular size, mass and function in relation to the duration and quantity of heavy drinking in alcoholics. The American journal of cardiology. 1991;67(4):274-9.
7. Engler R, Ray R, Higgins CB, McNally C, Buxton WH, Bhargava V, et al. Clinical assessment and follow-up of functional capacity in patients with chronic congestive cardiomyopathy. The American journal of cardiology. 1982;49(8):1832-7.
8. Thornton J. Atrial fibrillation in healthy non-alcoholic people after an alcoholic binge. The Lancet. 1984;324(8410):1013-5
9. Marriott HJ. Electrocardiographic abnormalities, conduction disorders and arrhythmias in primary myocardial disease. Progress in cardiovascular diseases. 1964;7(2): 99-114
10.Yoonhee C, Kooyoung J, Eunkyung E, Donghoon L, Junsig K, Dongwun S, et al. The relationship between alcohol consumption and injury in ED trauma patients. The American journal of emergency medicine. 2009;27(8):956-60.
11.Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. The lancet. 2009;373(9682):2223-33.
12.Lee MH, Mello MJ, Reinert S. Emergency department charges for evaluating minimally injured alcohol-impaired drivers. Annals of emergency medicine. 2009;54(4):593-9.
13. Eskandarieh S, Hajebi A, Noroozi A, Haghdoost AA, Baneshi MR. Epidemiology of alcohol abuse in Iran. Asia Pacific Journal of Medical Toxicology. 2014; 3:21-23
14.Calle PA, Damen J, De Paepe P, Monsieurs KG, Buylaert W. A survey on alcohol and illicit drug abuse among emergency department patients. Acta Clinica Belgica. 2006;61(4):188-95.
15.Pletcher MJ, Maselli J, Gonzales R. Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey. Am J Med. 2004;117(11):863-7.
16. Verelst S, Moonen P-J, Desruelles D, Gillet J-B. Emergency department visits due to alcohol intoxication: characteristics of patients and impact on the emergency room. Alcohol and alcoholism. 2012;47(4):433-8
17. Aasebø W, Aasebø W, Erikssen J, Jonsbu J, Stavem K. ECG changes in patients with acute ethanol intoxication. Scandinavian Cardiovascular Journal. 2007;41(2):79-84
18. Raheja H, Namana V, Chopra K, Sinha A, Gupta SS, Kamholz S, et al. Electrocardiogram changes with acute alcohol intoxication: A systematic review. The open cardiovascular medicine journal. 2018;12:1–6.
19.Borini P, Terrazas JHI, Ferreira Júnior A, Guimarães RC, Borini SB. Female alcoholics: electrocardiographic changes and associated metabolic and electrolytic disorders. Arquivos brasileiros de cardiologia. 2003;81(5):512-7.
20. Patel D, Singh p, Katz W, et al. QT interval prolongation in end-stage liver disease cannot be explained by nonhepathic factors. Ann Noninvasive Electrocardiol. 2014;19:574–81.
21. Mimidis K, PapadopoulosV , Thomopoulos K, et al. Prolongation of the QTc interval in patients with cirrhosis. Ann Gastroenterol. 2003;16:155–8.
22.Tsuji H, Venditti Jr FJ, Evans JC, Larson MG, Levy D. The associations of levels of serum potassium and magnesium with ventricular premature complexes (the Framingham Heart Study). Am J Cardiol.1994;74(3):232-5.
23.Raitt MH, Volgman AS, Zoble RG, Charbonneau L, Padder FA, O'Hara GE, et al. Prediction of the recurrence of atrial fibrillation after cardioversion in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. American heart journal. 2006;151(2):390-6.
24.Kalahasti V, Nambi V, Martin DO, Lam CT, Yamada D, Wilkoff BL, et al. QRS duration and prediction of mortality in patients undergoing risk stratification for ventricular arrhythmias. The American journal of cardiology. 2003;92(7):798-803.
25.Lorsheyd A, De Lange D, Hijmering M, Cramer M, Van de Wiel A. PR and OTc interval prolongation on the electrocardiogram after binge drinking in healthy individuals. Neth J Med. 2005;63(2):59-63.
26.Narahashi T, Kuriyama K, Illes P, Wirkner K, Fischer W, Mühlberg K, et al. Neuroreceptors and ion channels as targets of alcohol. Alcoholism: clinical and experimental research. 2001;25:182S-8S.
27.Reed SF, Porges SW, Newlin DB. Effect of alcohol on vagal regulation of cardiovascular function: contributions of the polyvagal theory to the psychophysiology of alcohol. Experimental and clinical psychopharmacology. 1999;7(4):484.
28. Brunner S, Herbel R, Drobesch C, Peters A, Massberg S, Kääb S, et al. Alcohol consumption, sinus tachycardia, and cardiac arrhythmias at the Munich Octoberfest: results from the Munich Beer Related Electrocardiogram Workup Study (MunichBREW). European heart journal. 2017;38(27):2100-6.
29. Raheja H, Namana V, Chopra K, Sinha A, Gupta SS, Kamholz S, et al. Electrocardiogram changes with acute alcohol intoxication: A systematic review. The open cardiovascular medicine journal. 2018;12:1.
30. Viswanathan S, Jain D, Vinayagamoorthi R, et al. (November 28, 2020) Electrocardiogram Heart Rate as a Predictor of Severity in Acute Alcohol-Related Pancreatitis With Alcohol Withdrawal Syndrome. Cureus 12(11): e11737. doi:10.7759/cureus.11737.
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