A 45 year old Indian male went to his doctor complaining of chest pain.

He was then
refereed to a specialist. In addition to chest pain the patient was complaining of head
aches and vague abdominal discomfort accompanied by heaviness felt in his upper left
arm. It should be noted that in addition to this, the patient also was constantly troubled
by his anxiety and worry of the future of his family and himself. Because he was the
breadwinner of his family he also dealt with the stresses of work. There was no history of
myocardial infection, hypertension, diabetes, or hyperlipidemia.

Patient was treated with emetine hydrochloride due to amoebiasis in 1965 and 1970. He
is a non smoker and non drinker. After physical examination no acute distress was
revealed. Heart rate was seventy beats per minute and blood pressure was one-forty over
eighty millimeters mercury. The neck showed no abnormalities with no jugular venous
distension, no thyromegaly, and no carotid bruits. All was normal with the heart too with
no click, gallop, or murmur detected. PMI was in the fifth intercostals space at
midclavicle line. First and second heart sounded normal. Lungs were clear to percussion
and auscultation. The abdomen was soft with no organomegaly. Extremities and
neurological exam was also normal. EKG diffuse ST and T wave abnormality. Was
suspicious for ischemic heart disease yet, an older EKG from 1972 matched current.
After treadmill stress test all is normal except for abnormal baseline EKG with no
significant change with exercise, probably negative for ischemia.

Overall impression was that patient had anxiety, abnormal EKG probably secondary to
emetine, and R/O Amoebiasis. Doctor believed EKG changes are secondary to
administration of emetine. Patient advised to do regular physical activity and told that he
does not have a heart disease. Doctor strongly recommended taking stool test to check for
amoebiasis and other worm infestations.

Use of the drug emetine against amoebiasis results in an abnormal EKG scan. This is
clearly visible on the patients EKG as well as in other reported cases. In one particular
case, the cardio toxicity was reported and several mechanistic interventions were
explored.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TCN-4037TN3-
15&_user=10&_coverDate=03%2F31%2F1995&_rdoc=1&_fmt=high&_orig=search&_
sort=d&_docanchor=&view=c&_searchStrId=1410724373&_rerunOrigin=google&_acct
=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b9c80970d4dd02963788
6e1e3835c6c8

In another case the cardio toxicity of emetine was also reported. The negative effect was
noted that on the isolated heart of a frog and guinea pig. The conclusion was that
“emetine is a drug with specific cardio toxicity”.

http://www.springerlink.com/content/x2744w041n262673/