CliffMadHoneyIndex

Mad Honey on the ECG: Bradycardia, AV Block, and What Clinicians See

Clinical reference chart showing five ECG patterns from mad honey grayanotoxin poisoning including sinus bradycardia, first and second degree AV block, complete third degree AV block and ventricular escape rhythm with corresponding treatments

Grayanotoxin poisoning is, above all, a cardiac conduction problem. The compound holds cardiac voltage-gated sodium channels open, amplifies vagal tone, and disrupts the heart’s pacemaker and conduction system. The electrocardiogram, or ECG, is the single most informative bedside tool for assessing how severely the system has been affected, because it shows the conduction disturbance directly. […]