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      Slow ventricular response atrial fibrillation related to mad honey poisoning

      case-report

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          Abstract

          Mad honey poisoning which is induced by Grayanotoxin (Andromedotoxin), is also known to have adverse effects in the cardiovascular system leading to different clinical entities. This toxin is produced by a member of the Rhododendron genus of plants of two R. Luteum and R. Panticum. In this article, we presented a case of slow ventricular response atrial fibrillation complaints with nausea, vomiting, dizziness and chest pain about an hour after eating honey produced in the Black Sea Region.

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          Poisoning by mad honey: a brief review.

          Ahmet Koca, Ilkay Kalkan (2007)
          Several plants of the Ericaceae family produce grayanotoxins which can poison humans. The best-known of these intoxications involves the eating of 'mad honey (deli bal in Turkish)' contaminated by Rhododendron nectar grayanotoxins. Accounts of mad honey intoxication date back to 401 BC. It is still one of the common food intoxications encountered for humans and livestock in Turkey. Mad honey intoxication's symptoms are dose-related. In mild form, dizziness, weakness, excessive perspiration, hypersalivation, nausea, vomiting and paresthesias are present and close follow-up is enough. However, severe intoxication may lead to life threatening cardiac complications such as complete atrioventricular block that can be treated intravenously. In this review, properties and sources of grayanotoxins, their detection methods and mad honey intoxication are discussed.
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            Hypotension, bradycardia and syncope caused by honey poisoning.

            M Eser, Atilla Sahiner, Özcan Yılmaz … (2006)
            Honey intoxication, a kind of food poisoning, can be seen in the Black Sea region of Turkey and in various other parts of the world as well. In this study, 66 patients were hospitalized with a variety of symptoms including nausea, vomiting, salivation, dizziness, weakness, hypotension, bradycardia and syncope several hours after the ingestion of small amounts of honey. All patients had hypotension, and majority had bradycardia. These features resolved completely in 24 h with i.v. fluids and atropine, and none died. In conclusion, honey poisoning should be taken into consideration in the differential diagnosis of acute myocardial infarction and in the patients with vomiting, hypotension and bradycardia.
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              Mad honey poisoning.

              Abdulkadir Gunduz, Murat Topbaş, H Uzun … (2006)
              Grayanotoxin intoxication, which is mostly seen in the eastern Black Sea region of Turkey, stems from the "mad honey" made by bees from the rhododendron plant flowers. In low doses, this causes dizziness, hypotension, and bradycardia, and in high doses, impaired consciousness, seizures, and atrioventricular block (AVB). This case study was designed as a series of cases of patients (6 women, 2 men) aged between 35 and 75 years. All of the patients' physical examinations revealed hypotension; 4 patients had sinus bradycardia, 3 had nodal rhythm, and 1 had complete AVB. In all patients, except for the patient with AVB, heart rate and blood pressure returned to normal limits within 2 to 6 hours. Two patients were monitored in the coronary intensive care unit. Of these 2, 1 was discharged on the second day. The other was fitted with a temporary pacemaker and was discharged on the third day. All the other patients were kept in for a 6-hour observation period and were then discharged from the ED. To date, 58 such cases have been reported, but we saw 8 patients within 2005. It is commonly seen in the east of the Black Sea region, although cases may occur from all over the eastern Black Sea region of Turkey. So far, no cases of death have been reported, although grayanotoxin causes adverse effects on the cardiovascular and respiratory systems and is therefore of considerable importance.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cardiovasc Dis Res
                Journal ID (iso-abbrev): J Cardiovasc Dis Res
                Journal ID (publisher-id): JCDR
                Title: Journal of Cardiovascular Disease Research
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 0975-3583
                ISSN (Electronic): 0976-2833
                Publication date (Print): Jul-Sep 2012
                Volume: 3
                Issue: 3
                Pages: 245-247
                Affiliations
                [1] Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
                [1 ] Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey
                Author notes
                Address for correspondence: Dr. Selcuk Yaylacı, Department of Internal Medicine, Sakarya University Faculty of Medicine, 54100 Sakarya, Turkey. E-mail: yaylacis@ 123456hotmail.com
                Article
                Publisher ID: JCDR-3-245
                DOI: 10.4103/0975-3583.98904
                PMC ID: 3425036
                PubMed ID: 22923947
                SO-VID: 155ef26b-faf3-4432-b0c8-ba510c023c85
                Copyright © Copyright: © Journal of Cardiovascular Disease Research
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Clinical Case Report Based Study

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: atrial fibrillation,mad honey,poisoning
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: atrial fibrillation, mad honey, poisoning

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