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Research Snapshot Theater: Cardiovascular, Adult V

A Rare Case of Strong Acid Poisoning Presenting With Refractory Electrical Storm

Monday, March 23, 2026
9:00 AM - 10:00 AM Central Time
Location: Connections Central - RST 02

  • Songsong Luo, n/a

    CHN

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • XS

    Xiaoyuan Shen, N/A

    physician
    Hangzhou Xiaoshan District First People's Hospital

    Disclosure information not submitted.

  • lM

    lujiao Mo, N/A

    physician
    Hangzhou Xiaoshan District First People's Hospital

    Disclosure information not submitted.

  • hd

    hongliang dong, N/A

    physician
    Hangzhou Xiaoshan District First People's Hospital

    Disclosure information not submitted.

  • LN

    Leyi Ni, N/A

    physician
    Hangzhou Xiaoshan District First People's Hospital

    Disclosure information not submitted.

  • JL

    Jiawei Lai, N/A

    physician
    Hangzhou Xiaoshan District First People's Hospital

    Disclosure information not submitted.

Introduction: Strong acid ingestion can cause catastrophic gastrointestinal and systemic damage. While corrosive injury is expected, development of refractory electrical storm (ES)-a life-threatening arrhythmia is exceedingly rare. Effective management strategies for such toxic cardiac complications remain unclear.


Description: A 62-year-old man ingested ~100 mL of industrial descaling agent containing hydrochloric and sulfuric acid. He presented with hematemesis and epigastric pain. Two hours after admission, he developed sudden loss of consciousness and suffered seven episodes of ventricular fibrillation (VF) consistent with electrical storm. Despite antiarrhythmic drugs (amiodarone, lidocaine, esmolol), electrolyte correction, and defibrillation, VF persisted. Labs revealed metabolic acidosis and hypocalcemia. Bedside echocardiography showed left ventricular ejection fraction (EF) of 30%. Due to refractory shock and arrhythmia, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated. The patient stabilized, and vasoactive agents were weaned by day 3. He was decannulated on day 9 with cardiac recovery. Endoscopy revealed corrosive gastritis, diffuse ulceration, and pyloric stenosis, later requiring jejunostomy. He was discharged from ICU after 17 days.


Discussion: This is a rare case of acid-induced ES requiring ECMO. The arrhythmia was likely triggered by hypocalcemia, acidosis, and direct myocardial toxicity. VA-ECMO provided circulatory support and a window for metabolic correction and myocardial recovery. This case emphasizes the importance of early recognition, multidisciplinary care, and the potential role of ECMO in managing toxic cardiac complications when conventional therapies fail.
Artificial intelligence assistance (ChatGPT, OpenAI) was used in the drafting and English-language editing of this case report. All clinical content and interpretations were verified by the authors.