Clinical Case: Alocasia macrorrhizos Poisoning and QTc Prolongation
Overview
This case report details a 75-year-old woman who experienced significant QTc prolongation and MINOCA-like symptoms following the ingestion of Alocasia macrorrhizos. The findings highlight the potential for toxic myocardial injury from plant ingestion, particularly in the context of chest pain and electrocardiographic abnormalities.
Background
Alocasia macrorrhizos is a plant known for its toxic properties, particularly due to calcium oxalate raphides, which can cause significant oral and pharyngeal irritation. This case is particularly relevant as it illustrates how poisoning from this plant can mimic acute coronary syndrome presentations, leading to potential misdiagnosis. Understanding the cardiac implications of such poisonings is crucial for timely and appropriate management.
Data Highlights
No numerical data or trial data is presented in the article.
Key Findings
The patient developed oral numbness, throat swelling, and chest pain after ingesting Alocasia macrorrhizos.
Initial ECG showed a QTc interval of 400 ms, which later prolonged to 590 ms upon hospital presentation.
Cardiac troponin I level was mildly elevated at 0.352 ng/mL, while other myocardial enzymes were normal.
Coronary angiography revealed no obstructive lesions, consistent with a MINOCA-like phenotype.
Supportive care led to resolution of symptoms and normalization of the QTc interval to 440 ms at follow-up.
Clinical Implications
Clinicians should be aware of the potential for toxic myocardial injury in patients presenting with chest pain and significant QTc prolongation, particularly following plant ingestion. Continuous ECG monitoring is recommended in such cases to detect and manage arrhythmias promptly.
Conclusion
This case underscores the need for awareness of plant toxins like Alocasia macrorrhizos, which can lead to serious cardiac manifestations. A thorough exposure history is essential in patients with unexplained chest pain and electrocardiographic abnormalities.
