Cardiogenic shock in a patient with glyphosate-surfactant poisoning
Lin, C.M.; Lai, C.P.; Fang, T.C.; Lin, C.L.
Journal of the Formosan Medical Association 98(10): 698-700
1999
ISSN/ISBN: 0929-6646 PMID: 10575841 Document Number: 501563
A case is presented of glyphosate-induced cardiogenic shock in a young man. The patient, a 26-year-old Chinese man, presented at the Tzu-Chi Buddhist General Hospital with nausea and vomiting 4 hours after attempting suicide by drinking 150 ml of Chun-Dou-Dou (41% isopropylamine salt of glyphosate + 15% polyoxyethylene-amine surfactant). Cardiogenic shock with accelerated idio-ventricular rhythm on electrocardiography developed after admission. Intravenous injection of epinephrine, atropine and calcium failed to improve the condition. Over the next 16 hours, the QRS complex gradually narrowed, sinus rhythm returned, and haemodynamic status improved. Echocardiograms revealed diffuse left ventricular hypokinesis with markedly reduced ejection fraction while the patient was in shock; normal left ventricular function resumed the next day. In this case, the glyphosate surfactant poisoning-induced shock may have been due to transient suppression of the cardiac conduction system and contractility, rather than intravascular hypovolaemia.