Fluoroacetate poisoning with ventricular fibrillation as the prominent clinical manifestation: a case report

Ventricular fibrillation (VF) is a common critical disease. The reason for VF is crucial for subsequent treatment. The common reasons for VF include acute coronary syndrome, heart failure, cardiomyopathy, and ion channel disease. This paper reports a case of VF caused by fluoroacetate poisoning. The patient, a 35-year-old man, was admitted to Peking University Third Hospital on September 21st, 2022 due to "chest tightness for 10 hours and loss of consciousness for 2 hours". After exposure to the suspected poison, the patient developed chest tightness, accompanied by slurred speech, fatigue, and subsequent sudden loss of consciousness. The electrocardiogram indicated VF, ventricular tachycardia, and ST segments elevation in some leads, elevated markers of myocardial injury. And the echocardiography showed the decline of left and right ventricular systolic function. A series of examinations indicated that the above manifestations were caused by fluoroacetate poisoning, and the patient recovered through hemofiltration and acetamide treatment. The case suggests that poisoning should be included in the differential diagnosis of the cause of VF, especially when patients have suspected exposure to toxic substances.