• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of heartHeartVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Heart. Dec 1999; 82(6): e11.
PMCID: PMC1729226

A young man with a heavy heart

Abstract

A 34 year old man presented with acute chest pain. His ECG was very abnormal but stable and he was treated with opiate analgesia. When his condition did not improve, chest radiography and cardiac ultrasound were performed. Both revealed metal dense deposits in the heart. On questioning, the patient revealed that he had self injected with mercury 15 years before. Self injection of elemental mercury is rare but well described and normally used by those who are suicidally depressed or who seek to improve sexual or athletic performance. Intravenous mercury may be deposited in the right heart and can result in ECG abnormalities, which may later be mistaken for changes due to coronary or other cardiac disease and result in inappropriate medication and hospitalisation.


Keywords: mercury poisoning; non-cardiac chest pain; analgesia

Full Text

The Full Text of this article is available as a PDF (92K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Broad WJ. Sir Isaac Newton: mad as a hatter. Science. 1981 Sep 18;213(4514):1341–1344. [PubMed]
  • Kedziora A, Duflou J. Attempted suicide by intravenous injection of mercury: a rare cause of cardiac granulomas. A case report. Am J Forensic Med Pathol. 1995 Jun;16(2):172–176. [PubMed]
  • Hohage H, Otte B, Westermann G, Witta J, Welling U, Zidek W, Heidenreich S. Elemental mercurial poisoning. South Med J. 1997 Oct;90(10):1033–1036. [PubMed]
  • Celli B, Khan MA. Mercury embolization of the lung. N Engl J Med. 1976 Oct 14;295(16):883–885. [PubMed]
  • Murray KM, Hedgepeth JC. Intravenous self-administration of elemental mercury: efficacy of dimercaprol therapy. Drug Intell Clin Pharm. 1988 Dec;22(12):972–975. [PubMed]
  • Burton EM, Weaver DL. Repeated systemic mercury embolization. South Med J. 1988 Sep;81(9):1190–1192. [PubMed]
  • Johnson HR, Koumides O. Unusual case of mercury poisoning. Br Med J. 1967 Feb 11;1(5536):340–341. [PMC free article] [PubMed]
  • Hill DM. Self-administration of mercury by subcutaneous injection. Br Med J. 1967 Feb 11;1(5536):342–343. [PMC free article] [PubMed]
  • Rodrigues IM, Hopkinson ND, Harris RI. Pulmonary embolism associated with self-administration of mercury. Hum Toxicol. 1986 Jul;5(4):287–289. [PubMed]
  • Torres-Alanís O, Garza-Ocañas L, Piñeyro-López A. Intravenous self-administration of metallic mercury: report of a case with a 5-year follow-up. J Toxicol Clin Toxicol. 1997;35(1):83–87. [PubMed]
  • Sergent G, Pichot E, Lheureux P, Gevenois PA. Metallic mercury embolization of the lung. J Belge Radiol. 1995 Aug;78(4):237–237. [PubMed]
  • Chitkara R, Seriff NS, Kinas HY. Intravenous self-administration of metallic mercury in attempted suicide. Report of a case with serial roentgenographic and physiologic studies over an 18-month period. Chest. 1978 Feb;73(2):234–236. [PubMed]
  • Kośmider S, Zajusz K, Klopotowski J. Electrocardiographic abnormalities and some myocardial enzymatic disturbances in experimental poisoning with metallic mercury. Pol Med J. 1967;6(3):651–661. [PubMed]
  • Anderson WJ. Intravenous mercury: a three year follow-up. Ulster Med J. 1993 Oct;62(2):180–183. [PMC free article] [PubMed]
  • Zillmer EA, Lucci KA, Barth JT, Peake TH, Spyker DA. Neurobehavioral sequelae of subcutaneous injection with metallic mercury. J Toxicol Clin Toxicol. 1986;24(2):91–110. [PubMed]
  • Işik S, Güler M, Oztürk S, Selmanpakoğlu N. Subcutaneous metallic mercury injection: early, massive excision. Ann Plast Surg. 1997 Jun;38(6):645–648. [PubMed]
  • Oliver RM, Thomas MR, Cornaby AJ, Neville E. Mercury pulmonary emboli following intravenous self-injection. Br J Dis Chest. 1987 Jan;81(1):76–79. [PubMed]

Figures and Tables

Figure 1
12 lead ECG at presentation showing widespread anterior and inferior T wave changes.
Figure 2
Chest x ray showing metal dense deposits within the cardiac silhouette at the apex of the right ventricle, and multiple small metal dense deposits scattered throughout both lung fields.

Articles from Heart are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...