Document Type : Case Report
Authors
Emergency Medicine Department, SBU Antalya Research and Training Hospital, Turkey
Abstract
Introduction: Scombroid poisoning is a condition that occurs after ingestion of seafood and can cause cardiac and respiratory effects, shock, and life-threatening conditions, as well as gastrointestinal findings caused by increased histamine levels.
Case Report: The detailed history of the 80-year-old male patient who presented to the emergency department with chest pain, nausea and vomiting revealed that he had consumed an excessive amount of anchovies 10 hours prior to admission. On follow-up, the patient's blood pressure was 142/66 mmHg and heart rate was 48/min. Bradycardia, PR interval prolongation and ST depressions were observed on the initial ECG. No troponin elevation was observed during the patient's follow-up in the emergency department, and the patient was treated with antihistamines, steroids, and fluid resuscitation, and his condition was assessed as scombroid toxicity. The follow-up ECG of the patient whose symptoms resolved after treatment showed that the bradycardia had resolved, the heart rhythm was 65 bpm, the PR interval prolongation had returned to normal, and the signs of first-degree AV block had resolved.
Conclusion: While tachycardia and bronchospasm have been observed in scambroid poisoning in the literature, in our case bradycardia was observed to develop as a result of vagal stimulation due to increased histamine. Increased histamine levels can cause life-threatening situations by producing bradycardia, which can develop into asystole with vagal nerve impulses. The use of antihistamines in the treatment of bradycardia, which is one of the effects of histamine, shows a good prognosis, as in our case.
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