Acute myocardial injury from carbon monoxide poisoning by cardiac magnetic resonance imaging

摘要

A 40-year-old patient presented to our emergency department with altered mental status and supraventricular tachycardia. His carboxyhaemoglobin level was detected at 14%. He was found to have developed myocardial injury with a typical troponin rise and fall peaking at 22.6 ng/mL. Coronary angiography demonstrated normal coronary arteries. A battery of inflammatory and viral serologies was also negative. Cardiac magnetic resonance (CMR) was performed to evaluate the patient's left ventricular function and myocardial damage. Steady-state free-precision cine demonstrated a mildly depressed left ventricular systolic function (ejection fraction of 54%) with hypokinesis of the anterior wall and regional akinesis of the.inferior wall (Supplementary data online, Videos S1 and S2). First-pass perfusion demonstrated even perfusion throughout all wall segments (Supplementary data online, Video S3). Late gadolinium-enhancement images demonstrated multiple focal areas of high signal consistent with myocardial necrosis or fibrosis (Panels A-D).