Broadening the Diagnostic Horizon in Carbon Monoxide Poisoning: Reflections on Tp-e/QTc and Lactate as Early Markers

This letter offers a critical yet appreciative perspective on the recent case report exploring the Tp-e/QTc ratio and blood lactate levels as early indicators of cardiac ischemia in carbon monoxide poisoning. While acknowledging the clinical relevance of the proposed markers, we suggest enriching the discussion with additional context on electrophysiological mechanisms, reference values, and patient outcomes. We commend the authors for drawing attention to an often-overlooked diagnostic challenge and highlight the need for future prospective validation.