TY - JOUR
T1 - Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion
T2 - Observations in one case and implications for mechanism of toxicity
AU - Vohra, Rais
AU - Velez, Larissa I.
AU - Rivera, Wilfredo
AU - Benitez, Fernando L.
AU - Delaney, Kathleen A.
PY - 2008/1
Y1 - 2008/1
N2 - Introduction. Hydrofluoric acid (HF) is a weak inorganic acid used for etching and as rust remover. Systemic toxicity is manifested as ventricular dysrhythmias. The mechanisms for these dysrhythmias are not well elucidated. Case report. An 82-year-old woman ingested 8 ounces of 7% HF. Shortly after emergency department (ED) arrival, she became pulseless, developing recurrent ventricular dysrhythmias. She was defibrillated 17 times and received several doses of calcium, magnesium, and lidocaine. After three hours, she returned to sustained NSR. She was discharged home after four days. Discussion. The electrocardiographic findings in this patient demonstrate hypocalcemia, which has been implicated as the culprit in HF-induced arrhythmias. However, despite correction of the hypocalcemia, the ventricular arrhythmias persisted. The proposed mechanisms of systemic HF toxicity and the relevant literature are discussed. Conclusion. Ventricular dysrhythmias due to HF toxicity seem to be independent of either hypocalcemia or hyperkalemia. Systemic toxicity after ingestions may be delayed and precipitous.
AB - Introduction. Hydrofluoric acid (HF) is a weak inorganic acid used for etching and as rust remover. Systemic toxicity is manifested as ventricular dysrhythmias. The mechanisms for these dysrhythmias are not well elucidated. Case report. An 82-year-old woman ingested 8 ounces of 7% HF. Shortly after emergency department (ED) arrival, she became pulseless, developing recurrent ventricular dysrhythmias. She was defibrillated 17 times and received several doses of calcium, magnesium, and lidocaine. After three hours, she returned to sustained NSR. She was discharged home after four days. Discussion. The electrocardiographic findings in this patient demonstrate hypocalcemia, which has been implicated as the culprit in HF-induced arrhythmias. However, despite correction of the hypocalcemia, the ventricular arrhythmias persisted. The proposed mechanisms of systemic HF toxicity and the relevant literature are discussed. Conclusion. Ventricular dysrhythmias due to HF toxicity seem to be independent of either hypocalcemia or hyperkalemia. Systemic toxicity after ingestions may be delayed and precipitous.
KW - Dysrhythmias
KW - Hydrofluoric acid
KW - Hyperkalemia
KW - Hypocalcemia
KW - Toxicology
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U2 - 10.1080/15563650701639097
DO - 10.1080/15563650701639097
M3 - Article
C2 - 17906993
AN - SCOPUS:37649001185
SN - 1556-3650
VL - 46
SP - 79
EP - 84
JO - Clinical Toxicology
JF - Clinical Toxicology
IS - 1
ER -