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

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.

Figure 1

(a) First ECG of the father, 66‐year‐old man, recorded on arrival at the Emergency Department. (b) ECG recorded in the same patient after detoxification measures (48 hr later)

Figure 2

(a) First ECG of the son, 36‐year‐old man, recorded on arrival at the Emergency Department. (b) ECG recorded in the same patient after detoxification measures (48 hr later)

Figure 3

(a) First ECG of the mother, 60 years old woman, recorded in the Intensive Care Unit, after placing temporary transvenous pacemaker. (b) ECG recorded in the same patient after detoxification measures and temporary pacemaker removal (72 hr later)