Korean Circ J.  2000 Jul;30(7):855-860. 10.4070/kcj.2000.30.7.855.

Cardiovascular aspects of aconitine poisoning

Abstract

BACKGROUND AND OBJECTIVES: The Oriental herbal materials known as aconitine have long been used in oriental traditional medicine for their analgesic and antiinflammatory effects. Aconitine and its related alkaloids are known cardiotoxins with no therapeutic role in modern western medicine. We have studied the cardiovascular side effects of intoxication that took place in otherwise healthy individuals after ingestion of herbal decoctions containing aconite alkaloids. MATERIALS AND METHOD: During a six-year interval from 1990 to 1996, 9 cases of accidental herb-induced aconitine intoxication were managed in Kyung Hee university medical center. Hospital records were reviewed in detail.
RESULTS
All patients developed symptoms of aconitine toxicity within 4 hours of herb ingestion. The frequency of the order in cardinal symptoms of acute aconitine poisoning was nausea or vomiting, irritability, chest discomfort, dizziness, etc. Nine patients developed arrhythmias, including multifocal APC with aberrancy, multifocal VPC, ventricular tachycardia, etc. Administration of isotonic saline, dopamine, atropine and lidocaine with supportive cares brought clinical recovery and disappearance of arrhythmias in most cases within several hours. However, one case of acute aconitine poisoning had been dead of cardiac arrest due to ventricular fibrillation.
CONCLUSION
Aconitine and its related alkaloids can cause toxic effects and even fatal poisoning. These cases point to the need for strict surveillance of herbal substances with low safety margins.

Keyword

Aconitine; Arrhythmia

MeSH Terms

Academic Medical Centers
Aconitine*
Aconitum
Alkaloids
Arrhythmias, Cardiac
Atropine
Cardiotoxins
Dizziness
Dopamine
Eating
Heart Arrest
Hospital Records
Humans
Lidocaine
Medicine, East Asian Traditional
Nausea
Poisoning*
Tachycardia, Ventricular
Thorax
Ventricular Fibrillation
Vomiting
Aconitine
Alkaloids
Atropine
Cardiotoxins
Dopamine
Lidocaine
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