Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12416-12421
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12416
Acute myocardial necrosis caused by aconitine poisoning: A case report
Yu-Ping Liao, Li-Han Shen, Li-Hua Cai, Jie Chen, Han-Quan Shao
Yu-Ping Liao, Li-Han Shen, Li-Hua Cai, Jie Chen, Han-Quan Shao, Department of Critical Care Medicine, Dongguan People’s Hospital, Dongguan 523058, Guangdong Province, China
Author contributions: Shao HQ and Liao YP designed the study; Cai LH and Chen J collected the data; Liao YP, Shao HQ, and Shen LH wrote the manuscript; All authors have read and approved the final manuscript.
Supported by Dongguan Science and Technology of Social Development Program, No. 202050715001213.
Informed consent statement: This study was approved by the Clinical Ethics Committee of Dongguan People’s Hospital (KYKT2021-028). Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Han-Quan Shao, Doctor, Associate Chief Physician, Department of Critical Care Medicine, Dongguan People’s Hospital, No. 3 Wandao Avenue, Wanjiang District, Dongguan 523058, Guangdong Province, China.
Received: September 3, 2022
Peer-review started: September 3, 2022
First decision: September 26, 2022
Revised: October 13, 2022
Accepted: October 24, 2022
Article in press: October 24, 2022
Published online: November 26, 2022

Herbal medicine has a long history of use in the prevention and treatment of disease and is becoming increasingly popular globally. However, there are also widespread concerns about its safety. Among them, the cardiotoxicity of aconitine has been described.


We report a case of a 61-year-old male with aconitine poisoning presenting with malignant arrhythmia and severe cardiogenic shock, which was successfully managed with aggressive advanced life support and heart transplantation.


This is the first case wherein in vivo cardiac pathology was obtained, confirming that aconitine caused acute myocardial necrosis.

Keywords: Aconitine, ECMO, Myocardial necrosis, Ventricular arrhythmia, Herbal medicine, Case report

Core Tip: Aconitine poisoning can cause severe cardiotoxicity. In this patient, aconitine poisoning led to life-threatening ventricular arrhythmia and cardiogenic shock, ultimately requiring a heart transplantation as a cure.