Bizarre and scary ECG in yew leaves poisoning: Report of successful treatment

Ann Noninvasive Electrocardiol. 2018 Sep;23(5):e12535. doi: 10.1111/anec.12535. Epub 2018 Feb 28.

Abstract

Yew leaves poisoning is a rare life-threatening intoxication, whose diagnosis can be difficult. Initial symptoms are nausea, vomiting, abdominal pain, dizziness, tachycardia, muscle weakness, confusion, beginning within 1 hr from ingestion and followed by bradycardia, ventricular arrhythmias, ventricular fibrillation, severe hypotension, and death. Taxine-derived alkaloids are responsible for the toxicity of the yew leaves, blocking sodium and calcium channels, and causing conduction abnormalities. Because of lack of a specific antidote and limited efficacy of common antiarrhythmic drugs, prompt diagnosis, detoxification measures, and immediate hemodynamic support (also with transvenous cardiac stimulation) are essential.

Keywords: poisoning; taxine; ventricular arrhythmias; yew leaves.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic alpha-Agonists / therapeutic use
  • Adult
  • Aged
  • Amiodarone / therapeutic use
  • Anti-Arrhythmia Agents / therapeutic use
  • Arrhythmias, Cardiac / chemically induced*
  • Arrhythmias, Cardiac / therapy
  • Cardiopulmonary Resuscitation
  • Cephalotaxus / poisoning*
  • Charcoal / therapeutic use
  • Electrocardiography / methods*
  • Female
  • Gastric Lavage
  • Heart Arrest / chemically induced*
  • Heart Arrest / therapy
  • Humans
  • Magnesium Sulfate / therapeutic use
  • Male
  • Middle Aged
  • Norepinephrine / therapeutic use
  • Pacemaker, Artificial
  • Plant Extracts / poisoning*
  • Plant Leaves / poisoning*
  • Sodium Bicarbonate / therapeutic use
  • Treatment Outcome

Substances

  • Adrenergic alpha-Agonists
  • Anti-Arrhythmia Agents
  • Plant Extracts
  • Charcoal
  • Magnesium Sulfate
  • Sodium Bicarbonate
  • Amiodarone
  • Norepinephrine