Sodyum Hipoklorit ve Hidroklorik Asit Karışımının İnhalasyonuna Bağlı Gelişen Miyokard Hasarı

Yıl 2019, Cilt: 2 Sayı: 4, 25 - 27, 31.12.2019

Esra Polat Mehmet Cihat Demir

Öz

Amaç

Sodyum hipoklorit (çamaşır suyu) ve hidroklorik asit ( tuz ruhu) ülkemizde temizlik amacı ile sık olarak kullanılır. Bu iki sıvının karıştırılması sonucunda zehirli klor gazı ortaya

çıkmaktadır. Klor gazının inhalasyonu, mukoz membranlarda irrirasyon, pulmoner gaz değişiminin engellenmesi ve pulmoner ödem nedeniyle ciddi solunum sıkıntısına neden olabilir. Nadiren kardiyovasküler sisteme de zarar verebilir.

Olgu

Bilinen kalp veya solunum hastalığı teşhisi konmamış 81 yaşında bir erkek hasta acil servise klor gazı maruziyeti nedeniyle lakrimasyon ve burun akıntısı şikayeti ile başvurdu. Aktif kardiyak şikayeti olmayan hastada troponin pozitifliği saptandı. Takibe alınan hastada takiplerinde troponin değerinde artış olması ve akut koroner sendrom dışlanamaması nedeni ile hastaya yapılan koroner anjiyografide koroner arterler plaklı olarak izlendi. Troponin yüksekliği sodyum hipoklorit ve hidroklorik asit karışımının inhalasyonuna bağlandı.

Sonuç

Klor gazına maruz kalma genellikle solunum sistemine zarar vermektedir. Bunun yanında, aritmi, akut koroner sendrom, kalp yetmezliği ve hatta ölüm gibi kardiyovasküler etkiler de görülebilir. Acil tıp doktorları klor gazına maruz kalan hastalarda kardiyovasküler etkilere dikkat etmeli ve kalp hastalığı öyküsü olmasa bile kardiyak hasarın gelişebileceğini düşünmelidir.

Anahtar Kelimeler

Sodyum hipoklorit, hidroklorik asit, troponin, miyokard hasarı

Myocardial Injury Due to Inhalation of A Mixture of Sodium Hypochlorite and Hydrochloric Acid

Öz

Aim

Sodium hypochlorite (bleach) and hydrochloric acid are chemicals, commonly used in household cleaning and can be dangerous when mixed with each other. As a result of the

mixture, chlorine gas is released which is poisonous. Inhalation of chlorine gas may cause severe respiratory distress due to irritation of mucous membranes, impaired pulmonary gas exchange, and pulmonary edema. Rarely, it also damages the cardiovascular system.

Case

An 81-year-old male patient, who had not been previously diagnosed with heart or respiratory disease, presented to the emergency department with a complaint of lacrimation and nasal discharge due to chlorine gas exposure. He had troponin positivity. Coronary angiography was performed due to the subsequently troponin increase. Coronary angiography revealed plaques. The cause of troponin increase was associated with the inhalation of chlorine gas.

Conclusion

Exposure to chlorine gas is commonly manifested by damage to the respiratory system. However, cardiovascular effects such as arrhythmia, acute coronary syndrome, heart

failure, or even death may also occur. Emergency medicine physicians should pay attention to these cardiovascular effects and consider that patients exposed to chlorine gas

may experience heart damage even if they do not have a history of heart disease.

Anahtar Kelimeler

Sodium Hypochlorite, myocardial injury, hydrochloric acid, troponin

Kaynakça

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