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
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
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