Manini et al listed ECG changes associated with adverse cardiovascular events in a patient with acute poisoning. The authors are from Mount Sinai School of Medicine, New York University and the New York City Poison Control Center.
Patient selection: suspected poisoning
Outcome: adverse cardiovascular event (shock, myocardial injury, dysrhythmia, cardiac arrest)
Parameters:
(1) presence of ectopy
(2) rhythm (sinus vs nonsinus)
(3) QTc interval in ms
(4) sex
Ectopy
Rhythm
QTc
Risk
present
NA
high
absent
nonsinus
moderate
sinus
>= 500 ms
above normal but <= 500 ms
low
normal
very low
where:
• The upper limit of normal for QTc was 469 ms for females and 449 ms for males.
Adverse Cardiovascular Events
64%
>38%
26%
4%
Other risk factors for adverse cardiovascular events:
(1) QT dispersion (difference between the longest and shortest QT interval) >= 50 ms
(2) ischemia or infarction
To read more or access our algorithms and calculators, please log in or register.
Specialty: Cardiology, Emergency Medicine, Toxicology
