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Case Reports
. 2021 Aug;8(4):3403-3407.
doi: 10.1002/ehf2.13389. Epub 2021 May 3.

Inhalation of publicly available indoor insecticide spray caused myocardial infarction type II: a case report

Dirk Habedank  1 , Beate Stubbe  2 , Ralf Ewert  2 , Alexandra Kroll  1 , Iskandar Atmowihardjo  1 , Birgit Habedank  3
Affiliations
Case Reports

Inhalation of publicly available indoor insecticide spray caused myocardial infarction type II: a case report

Dirk Habedank et al. ESC Heart Fail. 2021 Aug.

Abstract

We report on a 70-year-old woman who tried to eliminate ants from her kitchen by applying a publicly available insecticide spray. Immediately afterwards, she felt dyspnoea, superseded by heavy chest pain. High-sensitivity troponin concentration increased from 33 to 149 ng/L (cut-off 50 ng/L). Significant coronary stenosis was excluded by coronary angiography, and the myocardial damage was classified as myocardial infarction type II. After exclusion of other potential mechanisms, we consider a cardiotoxic effect of the insecticide mixture of cypermethrin, tetramethrin, and piperonyl butoxide possible. We conclude that consumer information has to be improved. This concerns sustainable control measures adapted to the target insect species (in this case, the black garden ant Lasius niger), and differentiation between authorized and non-authorized but notified products. The instructions for use should give clear information on vulnerable groups and recommend personal protective equipment. Physicians and authorities should be alert to cardiac side-effects of insecticides.

Keywords: Cypermethrin; Insecticide spray; Myocardial infarction type II; Non-professional use; Piperonyl butoxide; Tetramethrin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Chest X‐ray at emergency unit excluding pulmonary oedema and infiltration.
Figure 2
Figure 2
Coronary angiogram excluding progression of the coronary heart disease.
See this image and copyright information in PMC

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