Cardiac Arrhythmias and Aerosol “Sniffing”

Abstract Aerosol "sniffing," a variant of glue "sniffing," involves the deliberate inhalation of aerosol products and propellants. Approximately 65 deaths have been attributed to this practice. They have been predominantly sudden and generally lack conclusive autopsy findings. The cause of death has not been defined in most cases; however, various mechanisms have been postulated. The evidence suggests acute cardiac arrest as a frequent cause. It could result from the sudden onset of ventricular fibrillation due to sensitization of the heart to epinephrine by inhalation of high concentrations of aerosol contents. Experimental investigation revealed that the commonly used aerosol propellants, in high concentrations, are capable of sensitizing the heart to epinephrine resulting in serious cardiac arrhythmias. Therefore, it is concluded that cardiac sensitization is a likely mechanism of death in many of the aerosol-sniffing fatalities.