Inhalational oleander toxicity was considered in a family of 4 by history of exposure to smoke from burning oleander twigs. Electrocardiography revealed first- and second-degree atrioventricular block with digoxin-like ST-T-wave changes, suggestive of oleander toxicity in the absence of exposure to digoxin or other herbal medicines, and without systemic illness. Complete blood count, biometabolic profile, chest x-ray, and echocardiography did not reveal any abnormalities. Electrocardiographies normalized within 4 days when kept away from offending agents. Because oleander plant materials are used for burning, people are exposed to inhalational oleander toxicity. Hence, practitioners shall consider such poisonings in them.
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