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Tex Heart Inst J. 2009;36(4):342-4.

Atrioventricular block induced by mad-honey intoxication: confirmation of diagnosis by pollen analysis.

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Department of Cardiology, Ankara Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.


An unusual type of food poisoning, mad-honey intoxication, can be observed in the Black Sea region of Turkey and various other parts of the world. It can occur after ingestion of grayanotoxin-contaminated honey produced from the nectar of Rhododendron ponticum and other plant species, chiefly of the Ericaceae and Sapindaceae families. Mad-honey intoxication can result in severe cardiac complications, such as complete atrioventricular block. The diagnosis is generally reached on the basis of the patient's history of honey intake. In this report, we describe the case of a patient who had mad-honey-related complete atrioventricular block; in this instance, the diagnosis was confirmed by a pollen analysis of the suspect honey.


Atropine/therapeutic use; bradycardia/chemically induced; diterpenes/poisoning; food poisoning/complications/diagnosis/therapy; heart block/chemically induced; honey/poisoning; hypotension/chemically induced; ion channels/drug effects; muscarinic antagonists/therapeutic use; plants, toxic/poisoning; pollen analysis; rhododendron; syncope/chemically induced; toxins, biological

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