Taxine alkaloid poisoning successfully supported with V-A ECMO: a case report

Ingestion of the berries of the European Yew tree can result in fatal cardiac arrhythmias. A 53-year-old female presented to our emergency department following ingestion of approximately 200 European Yew tree berries. At presentation she was in cardiogenic shock due to a mixture of tachy and brady arrhythmias including ventricular tachycardia, atrial fibrillation with slow ventricular response and prolonged ventricular conduction and periods of asystole. She was referred to a specialist cardiac centre and promptly established on mechanical circulatory support with venoarterial extracorporeal membrane oxygenation (V-A ECMO) by a retrieval team. Following resolution of her arrhythmias she was weaned from V-A ECMO after 4 days of support and was discharged home with full neurological recovery on day 12. Poisoning can lead to acute reversible but potentially fatal cardiogenic shock. We believe that access to prompt initiation of V-A ECMO was key to this patient’s survival.