Myocardial injury mimicking acute myocardial infarction from methane gas intoxication: a case report and literature review

Methane gas is a colorless and suffocating gas. We described the first case of methane gas intoxication in which the patient showed lethal myocardial injury. A 45-year-old man was presented to our hospital with unconsciousness after an accidental exposure to methane gas for 3 hours. On admission, serum troponin I was mild elevated. The initial electrocardiogram (ECG) showed sinus tachycardia. After 3 days, ECG showed diffuse elevation of the ST segment, and the patient developed refractory ventricular fibrillation (VF) and cardiac pump failure and died. However, coronary artery angiography showed that there was no occlusion. Therefore, it is possible that ischemic changes on the later ECG can predict in-hospital adverse cardiovascular events for methane gas intoxication.