The abuse of inhalants has become a public health concern in the USA over the past decade. Compressed air duster cans currently available in the USA contain highly toxic substances including different hydrofluorocarbons (including tetrafluoroethane and difluoroethane) which exert a psychoactive effect on the central nervous system. Several cases of inhalant-induced lethal arrhythmia such as ventricular fibrillation evolving to torsade de pointes and leading to cardiac arrest, have been reported in the literature. Furthermore, multiorgan failure including liver and kidney injury has been described after inhalant abuse. We report the case of a 33-year-old man found diaphoretic and with a near syncopal episode after inhalation of several cans of Surf Onn electronic duster gas cleaner, who subsequently developed acute cardiac, liver and kidney injury.
Learning points: Although the pathophysiological mechanisms have not been fully elucidated, the hydrofluorocarbons in air duster cans may exert a psychoactive effect through GABA receptor stimulation and NMDA receptor inhibition.Clinicians should maintain a low threshold of suspicion for patients presenting with multiorgan failure, predominantly cardiac arrhythmias after inhalant overdose.Prompt recognition and early intervention are imperative for preventing fatal outcomes such as cardiac arrest secondary to life-threatening cardiac arrhythmias.
Keywords: Inhalant; cardiac injury; electronic dusters; tetrafluoroethane.
© EFIM 2022.