Cardiac toxicity with nodal bradycardia due to Panama rubber (Castilla elastica: Moraceae) poisoning.

Plant poisoning is not an uncommon problem in Sri Lanka. A hospital based prospective study showed that Jatropha curcas, Ricinus communis, Dieffenbachia, Adenia palmata, Amanita phalloides and Thevetia peruviana are common poisonous plants implicated in poisoning among children in Sri Lanka. [1]. In the past, deliberate ingestion of yellow oleander seeds (Thevetia peruviana) was a common method of self-harm in north central part of Sri Lanka. The case-fatality rate of untreated patients was at least 10%. Seeds of yellow oleander contain cardiac glycosides which cause cardiac dysarrhythmias [2].