We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Notes |

Phosphorus Poisoning Simulating Acute Myocardial Infarction

Raymond J. Pietras; Charalambos Stavrakos; Rolf M. Gunnar; John R. Tobin Jr.
Arch Intern Med. 1968;122(5):430-434. doi:10.1001/archinte.1968.00040010430011.
Text Size: A A A
Published online


Elemental yellow phosphorus marketed in collapsible tubes as a rat poison and an insecticide, is an extremely toxic substance readily available in drug, grocery, and hardware stores as Electric Paste (net weight 62.5 gm, 2.5% [1.57 gm] elemental yellow phosphorus by weight). In a total of 115 patients attempting suicide with Electric Paste, Diaz-Rivera et al1,2 recorded 35 (30%) deaths. Acute cardiovascular collapse accounted for the majority of the deaths.

The heart is one of many organs affected by phosphorus, and several electrocardiographic abnormalities have been reported.1-4 However, changes diagnostic of or consistent with myocardial infarction have not been described. Recently we treated a patient with acute phosphorus poisoning whose electrocardiogram disclosed changes ordinarily interpreted as evidence of acute infarction of the anterolateral wall of the left ventricle. Rapid resolution and, ultimately, disappearance of the abnormal electrocardiographic pattern for myocardial infarct occurred within two weeks. At that time, a vectorcardiogram failed to demonstrate any deformation of the spatial QRS loop suggestive of myocardial infarction.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

19 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.