Abstract
A tempted suicide by carbon monoxide (CO) inhalation is very common in japan, and it is well understood that CO poisoning leads to a reduced level of consciousness. However, it is not widely understood that CO poisoning also reduces cardiac function. A 29-year-old male was found unconscious in a car with a small portable propane-gas cooking stove and was transported to hospital by ambulance. On arrival, Japan Coma Scale score was 200, pulse rate was 145 beats per minute, blood pressure was 124/80mmHg, and carbon monoxide hemoglobin (CO-Hb) level was 49.6%. The CO-Hb level suggested impaired consciousness was due to CO poisoning, and 100% oxygen was administered through a tracheal tube. A lowered left ventricular ejection fraction value was revealed by echocardiography and a high troponin I value was also observed, indicating concomitant onset of myocardial damage. Hyperbaric oxygen therapy (HBOT) was initiated, which improved the LVEF value and level of consciousness, and increased urine volume. This indicates that echocardiographic and troponin I examinations should be carried out in order to find any myocardial damage due to CO poisoning. In addition, the results in this case suggest that HBOT is effective in improving the level of consciousness and myocardial function.
