Document Detail

ST-segment elevation and ventricular tachycardia after ingestion of a common ornamental plant-a case report.
MedLine Citation:
PMID:  22572505     Owner:  NLM     Status:  MEDLINE    
Japanese yew is a widely used ornamental plant. However, most people are unaware that it is also a poisonous plant. It has potent cardiac toxicities that can lead to sudden cardiac death. A 37-year-old female patient presented to the emergency room with altered mental status and sustained ventricular tachycardia (VT). Electrocardiogram (ECG) after cardioversion showed profound QRS prolongation and ST-segment elevation suggestive of either hyperkalaemia, acute myocardial ischaemia, or Brugada syndrome. Her electrolytes and coronary angiography were normal. After improvement of the patient's mental status, she admitted that she has been consuming Japanese yew from her yard for several months. Few hours later, QRS duration normalised, but mild ST-segment elevation persisted in the right pre-cordial leads, making it more suspicious for Brugada syndrome. However, a procainamide challenge test and electrophysiology study failed to induce typical Brugada pattern ECG and VT. The absence of coronary artery disease and electrolytes disturbances points toward the fact that her arrhythmia and ECG changes are secondary to yew intoxication. The patient was monitored for a few days. She was haemodynamically stable and has not had any arrhythmia. This case highlights the importance of public awareness of severe toxicity from Japanese yew or other yew plants. Yews contain taxines that are responsible for the ECG abnormalities due to its inhibitory effect on the cardiac sodium and calcium channels. They cause conduction abnormalities, VT, and ST-segment elevation that can resemble acute myocardial infarction, hyperkalaemia, and Brugada syndrome.
Rami A Jambeih; Wassim H Shaheen; Vuy Y Li; Mazen H Shaheen
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-04-28
Journal Detail:
Title:  Indian heart journal     Volume:  64     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-05-10     Completed Date:  2013-07-10     Revised Date:  2014-03-28    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  India    
Other Details:
Languages:  eng     Pagination:  211-3     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
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MeSH Terms
Brugada Syndrome / diagnosis
Diagnosis, Differential
Electric Countershock
Electrophysiologic Techniques, Cardiac
Plant Poisoning / diagnosis*
Tachycardia, Ventricular / etiology*,  therapy

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