Acute Heart Failure in a Healthy Young Patient after Severe Carbon Monoxide Poisoning

INTRODUCTION: Carbon monoxide (CO) poisoning may cause severe cellular hypoxia. MATERIALS AND METHODS: A 28-year-old male presented reduced levels of consciousness and dyspnoea after CO exposure. Clinical examination revealed tachypnoea, bilateral rales, dilated jugular veins and confusion. Troponin I, lactate and carboxyhaemoglobin levels were increased. Thoracic X-ray depicted pulmonary oedema and an echocardiogram, severe heart failure (HF; EF<25%). He was intubated due to clinical deterioration. RESULTS: He remained intubated for 5 days with excellent improvement of left ventricular function (EF>55%). He was discharged 1 week later with full recovery. DISCUSSION: Acute HF is a rare serious complication of CO poisoning, even in healthy young individuals. LEARNING POINTS: Acute CO poisoning is an emergent condition necessitating prompt diagnosis and treatment. Neurologic and cardiovascular manifestations are the most worrying complications, which may leave permanent sequelae. Acute heart failure is a rare complication of CO poisoning, characterized by regional or global left ventricular wall hypokinesia.