Very Late Stent Thrombosis in a Patient Presenting with Acute Carbon Monoxide Poisoning

Address for Correspondence: Selçuk Öztürk, Department of Cardiology, Ankara Research and Training Hospital, Ankara, Turkey E-mail: [email protected] ©Copyright 2016 by Emergency Physicians Association of Turkey Available online at www.jemcr.org Introduction Carbon monoxide (CO) is known to be an inodorous, colorless, and non-irritating gas. It is commonly known as the silent killer. The toxicity of CO has been known for years, and it is one of the main causes of unintentional poisoning deaths in European countries. The main pathophysiological mechanism is dependent on the capability of CO to bind to hemoglobin with a high affinity, which displaces oxygen and forms carboxyhemoglobin (COHb), in which oxygen cannot be delivered to the cells. The brain and the heart, which are more prone to injury, need more oxygen than the other organs; therefore, neurological and cardiovascular manifestations are the most common results of acute CO poisoning. The cardiac effects of CO poisoning include angina, arrhythmia, cardiomyopathy, cardiogenic shock, and even sudden death (1). Acute myocardial infarction (AMI) secondary to CO poisoning is frequently reported in the literature (2, 3); however, there are no published data of very late thrombosis of tacrolimus drug-eluting stents with acute CO poisoning. Here we describe a case of very late stent thrombosis in a patient with CO poisoning.