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J Korean Soc Emerg Med > Volume 8(3); 1997 > Article
Journal of The Korean Society of Emergency Medicine 1997;8(3): 434-440.
Case of Ventricular Tachycardia After Caowu-Ingestion
Seok Cheon Hyun, Seong Reol Kim, Sang Moon Park, Hyun Lee, Kab Deug Kim, Hwa Shik Song
ABSTRACT
Aconitum species have been used in western and eastern medicine for centuries. In present, chinese medicine uses the drug to treat weak constitution, poor metabolism, dysuria, cardiac weakness, gout rheumatism in the limbs, neuralgia. Poisoning may occur from intentional or accidental ingestion, and the concentration of the toxic alkaloids - aonitine, mesaconitine, and hypoconitine - varies depending on species, place of origin, time of harvest, and processing procedure. In addition to cardiac arrhythmias, and hypotension, the alkaloids cause GI upset & neurological symptoms, especially numbness of the mouth and parethesia in the extrimities. The alkaloid causes a prolonged sodium current in cardiac muscle with slowed repolarization. The aconitine acts as a agonist of Na-channel receptor. Vaughan-Williams' classification I antiarrhythmic agents which belong to might be the first choice for the therapy of aconitine induced arrhythmias. The modification of the sodium system by aconitine seems to be responsible for the prolongation of the action potential and the appearance of extrasystoles and fibrillation. We experienced a 67-year-old male patient who suffered chest discomfort and palpitation with ventricular tachycardia through to be caused by aconitine. After treatment for 3days he recovered well and discharged. We report this case with literature review.
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