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Abstract
Background
Ingestion of the berries of the European yew tree can result in fatal cardiac arrhythmias.
Case summary
A 53-year-old female presented to our emergency department following ingestion of ∼200 European yew tree berries. At presentation, she was in cardiogenic shock due to a mixture of tachy- and bradyarrhythmias including ventricular tachycardia, atrial fibrillation with slow ventricular response and prolonged ventricular conduction, and periods of asystole. She was referred to a specialist cardiac centre and promptly established on mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (V-A ECMO) by a retrieval team. Following resolution of her arrhythmias, she was weaned from V-A ECMO after 4 days of support and was discharged home with full neurological recovery on Day 12.
Discussion
Poisoning can lead to acute reversible but potentially fatal cardiogenic shock. We believe that access to prompt initiation of V-A ECMO was key to this patient’s survival.
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Details
1 Department of Critical Care, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
2 Department of Cardiothoracic Surgery, Royal Brompton & Harefield NHS Foundation Trust, London, UK
3 Department of Intensive Care, Adult Intensive Care Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK