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. 2024 Feb 8;17(1):19.
doi: 10.1186/s12245-024-00588-3.

Intentional intoxication with monkshood plant leading to atrioventricular dissociation and ventricular ectopy in a 17-year-old female: a case report

V W Klokman  1   2 , S Tempelaar  3 , B C W Kuipers  3 , I A G van Dijk  3 , M A M Moviat  4
Affiliations

Intentional intoxication with monkshood plant leading to atrioventricular dissociation and ventricular ectopy in a 17-year-old female: a case report

V W Klokman et al. Int J Emerg Med. .

Abstract

Background: Monkshood, a toxic plant containing a potent cardio- and neurotoxin called aconitine, can lead to a range of symptoms, including nausea, vomiting, dizziness, seizures, and cardiac arrhythmias. Mortality associated with this intoxication are due to ventricular tachyarrhythmias which are difficult to treat and often refractory in nature.

Case presentation: We present a case of a 17-year-old female patient who presented to the emergency department after intentionally ingesting a monkshood plant and developed atrioventricular dissociation and frequent ventricular ectopy. The patient was successfully treated with activated charcoal, supportive care, and cardiac monitoring.

Conclusion: This case highlights the importance of early recognition of aconitine poisoning and the need for prompt supportive care, cardiac rhythm monitoring, and preemptive antiarrhythmic treatment planning.

Keywords: AV dissociation; Aconitine; Arrythmia; Emergency medicine; Monkshood plant; Poisoning.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Initial electrocardiogram upon emergency department arrival (1.5 h after ingestion) showing varying PR times with signs of AV dissociation and an accelerated junctional rhythm
Fig. 2
Fig. 2
Second electrocardiogram made in the emergency department (2 h after ingestion) showing varying PR times with signs of AV dissociation, an accelerated junctional rhythm, and ventricular ectopy
Fig. 3
Fig. 3
Electrocardiogram 12 h after admission (13.5 h after ingestion) with now normalization to a sinus rhythm
See this image and copyright information in PMC

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