A study of myocardial injury in organophosphorous poisoning.

Organophosphorous (OP) pesticide self-poisoning is estimated to kill around two lakhs population per year, largely in pacific asian region , majority of incidences takes place in rural populations and is mostly due to impulsion. In western population the scenario is different that is more incidence of poisoning with drugs takes place. In India the mortality is around one fourth to one fifth; but in western it is only less than one percent(1). Even developed countries are prone to military or terrorist attacks with nerve agent OP compounds. The main mechanism of action of all OPs is that they inhibit the enzyme acetyl cholinesterase. Majority of the mortality is due to cardiorespiratory compromise. But the clinical manifestations vary with type of insecticide and amount of insecticide consumed. In a clinical study 38 percent of patients require intubation for respiratory compromise following that the death rate was also high (2). If cardiac complications are not recognised early it can be fatal. 1 The exact pathogenesis of cardiac complications has not yet been defined. A few important studies have been carried out both in India and abroad to study the cardiac complications and electrocardiographic changes in organophosphorous poisoning. The current study was carried out to understand the cardiac manifestations of organophosphorous poisoning with special reference to cardiac enzymes and ECG changes