Cardiovascular complications of poisoning

Cardiovascular complications are common in poisoned individuals and require prompt attention and intervention. The pathophysiology of the cardiovascular complications depends on the substances involved, which are often unknown. An initial assessment and investigations are key to detecting cardiac disturbances and their cause. Arrhythmias resulting from poisoning in the form of tachycardias and bradycardias are relatively common with some substances such as sympathomimetics or β-adrenoceptor blockers. Changes in electrocardiogram intervals are also common manifestations, not only because of the action of these substances, but also secondary to disturbances of pH or electrolytes. Here we describe an approach to managing patients with exposure to cardiovascular poisoning including clinical assessment, investigations and management.