Miocarditis, secondary to intoxication with sodium monfluoracetate

Abstract

Sodium fluoracetate known as "compound 1080" and in Colombia called "Matarratas Guayaquil" is a rodenticide that has become an important cause of intoxication in this country. We show the case of a female aged 18, who attempted suicide by ingesting 30 cc of "Matarratas Guayaquil". She was admitted to the hospital with a blood pressure of 90/70mmHg, heart rate of 100 bpm and respiratory rate of 18 per minute without other important findings in the physical examination. Gastrointestinal decontamination and also ethanol IV were initiated. Fifteen hours after admittance she started dyspnea, hypotension and tachycardia and with some murmurs in the left lung base. Chest x-rays showed diffuse infiltrates suggesting pulmonary edema. EKG evidenced an increased QTc segment with a mild ST-Elevation in DII and DIII leads and also disorders of repolarization with inverted T waves. The echocardiography revealed a systolic-diastolic dysfunction. Troponine-I was positive (0,6 ng/ml). A toxic myocarditis was diagnosed and the clinical evolution was towards improvement. The patient was discharged eight days later. We reviewed the pathophysiology, clinical manifestations placing special emphasis on myocarditis, we also discuss the treatment given to this patient with particularity in ethanol management as an alternative source of redox equivalents to generate ATP based energy.