Fatal suicidal poisoning with antituberculosis agents with ST elevation and acute coronary syndrome symptoms--a case report.

A 19-years old, previously healthy male, ingested the higher amount of rifampicin, isoniazyd, pyrazinamide, ketoprofene and alcohol. Within less than 20 hours he developed dyspnoe, pruritus, red man syndrome, and ECG changes suggesting acute coronary syndrome appeared - ST interval elevation. In the next few hours chest pain appeared and troponin I concentration was elevated (13.54 ng/ml). The performed echocardiography revealed global hypokinesis with the decreased left ventricular ejection fraction (approx. 30%). There was no significant pathological changes in coronarography, except for slowed blood flow. Further patient developed cardiogenic shock, pulmonary oedema and died within 32 hours from medication overdose.

[Thrombolytic therapy of myocardial infarction in municipal hospital in years 1999-2005]. / Trombolityczne leczenie zawalu serca w szpitalu bez pracowni hemodynamicznej w latach 1999-2005.

UNLABELLED: The aim of the work was to assess the treatment of patients in whom acute myocardial infarction with ST elevation (STEMI) was diagnosed. MATERIAL AND METHODS: Among 889 patients with STEMI 302 persons (34%) were transferred to hospitals with possibility of making primary percutaneous coronary intervention (PCI) without thrombolytic therapy, in 132 persons (15%) thrombolytic therapy was done and in 455 patients (51%) such treatment was not done for the lack of indications or existing contraindications. RESULTS AND CONCLUSIONS: The increasing number of patients transferred to primary PCI immediately from Emergency Ward and the decreasing number of patients qualified to thrombolytic therapy was observed. It is the effect of wider access to primary PCI as the method of choice for treatment and the common application of the ESC standards by the doctors. Abolishment of age criterion as the contraindication to thrombolytic therapy made that average of patients age cured with thrombolysis still increases. The time exceeding 12 hours from the beginning of pain to the admittance to hospital is the main reason (59%) of rejection from thrombolytic therapy. The analysis of complications after the treatment does not show them to be multiple. The stroke as the most serious one did not take place. Two cases of serious bleeding from digestive tract in older ladies have been observed. The hypotony after streptokinase was observed in 14% of patients. This is only side effect, efficiently treated either with 100-200 mg of hydrocortisonum i.v. or/and the partial stopping of dosing medicament.