ACUTE ORGANOPHOSPHATE POISONING;

Introduction: Organophosphate poisoning (OP) is a serious public healthproblem. Cardiac manifestations are seen in majority of patients with OP and may range fromsinus tachycardia to more serious ventricular tachyarrhythmias. Objectives: To determinethe electrocardiographical manifestations of acute organophosphate poisoning at a tertiarycare hospital. Study Design: Observational study. Setting: Department of Medicine, AbbasiShaheed Hospital, Karachi. Period: February 2011 to August 2011 over a period of six months.Patients and methods: All patients of either sex presenting with the history or evidence ofexposure to organophosphorus compounds within 24 hours with characteristics manifestationsof organophosphate poisoning were included in the study. Electrocardiographic manifestationswere observed before the institution of medical therapy. Results: A total of 123 patients, 81(65.9%) male and 42 (34.1%) female were included in the study. The Mean (+SD) age ofthe study participants was 29.07 (+ 9.61) years. Majority (74%) patients had age <35 yearsand 78 (63.4%) patients in this study had time duration of <6 hours between ingestion oforganophosphorus and institution of therapy. The overall electrocardiographic changes wereobserved in 86.2% of patients. Out of these, ST elevation was seen in 19.8%, T-wave inversion in17.9%, prolonged PR interval in 9.4%, atrial fibrillation in 6.6% and prolonged QTc interval seenin 46.2%. Conclusion: Electrocardiographical changes are common manifestation of acuteorganophosphate poisoning. Prolonged QTc interval and ST segment elevation are the mostcommon finding in our patients. As these changes in ECG can lead to serious consequences,therefore it should be carefully evaluated in every patient with OP so that early intervention canbe done.