What are cardiac markers for carbon monoxide (CO) toxicity?

Updated: Sep 18, 2018
  • Author: Guy N Shochat, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

The ACEP recommends obtaining an electrocardiogram and cardiac biomarker levels in emergency department patients with moderate to severe CO poisoning (level B recommendation). [24] Cardiac marker results include the following:

  • Elevated high-sensitive troponin I levels often indicate cardiomyopathy, including reversible global dysfunction and a Takotsubo-like pattern [26]

  • Myocardial ischemia is common in patients hospitalized for moderate-to-severe CO exposure and is a predictor of mortality. [27]

  • Patients with preexisting cardiovascular disease can experience increased exertional angina with HbCO levels of just 5-10%; at high HbCO levels, even young healthy patients develop myocardial depression


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