Heart Failure with Preserved Ejection Fraction - A Rare and Late Complication of Organophosphorus Poisoning

Organophosphorus poisoningis a major medical and public-health problem across rural Asia. Here we highlight an unexpected and late cardiac complication of cardiomegaly and heart failure in a young patient post organophosphorus consumption.A 24-year-old female with no known comorbidities presented to ED 3 hours after consumption of insecticide, with symptoms typical of Organophosphorus poisoning and was managed on the lines of poisoning. Late during the hospital course, she developed sudden onset retrosternal heaviness. Serial ECGs showed non-specific ST changes with negative cardiac markers, increased cardiothoracic ratio on X-ray and raised NT-ProBNP. A Tc99m SISTAMIBI rest cardiac scan confirmed infero-basal myocardial ischemia and was managed medically.