Winter Heart Attack – The Hidden Impact of Carbon Monoxide

I have coined a term, “winter heart attack”, to describe what I believe to be a large number of carbon monoxide related cardiac arrests and heart attacks, that are caused by carbon monoxide poisoning. It is likely that in many of these cases the true triggering phenomenon – carbon monoxide poisoning – is never identified.

The term “Winter Headache” has long been used to describe the situation of getting headaches in the winter flu season, not because of a virus, but because of carbon monoxide exposure. For the same reasons that carbon monoxide is grossly undiagnosed in winter headache, I believe it is undiagnosed in winter heart attack. See

A recent study by researchers at the Rhode Island Hospital provides further backup to my hypothesis that carbon monoxide poisoning is a much bigger culprit in heart problems during the winter than diagnosed.

The common thinking about the mechanism of Carbon Monoxide Poisoning is oxygen deprivation (hypoxia). SinceCarbon Monoxide interferes with the blood’s capacity to carry oxygen, insufficient oxygen reaches the bodies organs, including the heart, causing damage. But according to this study published in the January issue of Academic Emergency Medicine, CO also causes a more toxic damage to the heart muscle, not related to oxygen deprivation. This can not only cause a heart attack, but could also cause long term damage.

Perhaps there is a cart and the horse issue here. I have been saying that Winter Heart Attack, is misdiagnosed, because no doctor thinks to look for a complex diagnosis, when someone with known heart disease has a heart attack. But the carbon monoxide may actually have created the defect as well.

“These findings suggest that heart damage caused by carbon monoxide may have long-lasting effects even after its been eliminated from the blood, making the diagnosis of carbon monoxide poisoning even more critical,” said lead author Selim Suner, M.D., M.S., director of emergency preparedness and disaster medicine at Rhode Island Hospital.

“While this research puts us one step in the right direction, there is still much more we need to know about the underlying mechanisms if we hope to someday develop targeted treatments,” added Suner, who’s also an associate professor of emergency medicine, surgery and engineering at The Warren Alpert Medical School of Brown University.

The study is the first to show that Carbon Monoxide’s effect on heart muscle is unrelated to oxygen deprivation in the recovery phase, even when all CO is out of the system.


I realize that I am a lawyer, one of those people who are always accused of drumming up lawsuits. But our civil justice system is about compensating individuals for all of the damages wrongfully caused by others, even the damages missed by others. What this study is telling us is that Carbon Monoxide poisoning cannot only cause death, heart attack, brain damage, but it can also cause additional permanent heart damage in those who survive, ultimately shortening life expectancy.

Every day there is another story about a group of people who were hospitalized for CO poisoning. Every day, those people are treated and released, with a seemingly clean bill of health. If they hired a lawyer, the lawyer would likely be scratching his head, trying to determine why this particular case merited any real effort. The lesson of this Rhode Island Hospital study, of the delayed effects theme I have repeated often on here, is that don’t judge the extent of damage from CO poisoning, based upon the 24 hour window.

Carbon monoxide poisoning is called the great mimicker for a reason. It acts like flu at first. It can put on the veil of so many other diseases, heart disease, dementia, headache – because it is a toxin, let loose in the blood stream capable of damaging any part of the body. We must think about all of the places this toxin could cause damage. We must think about the possibility that Carbon Monoxide could be the culprit, when someone reports symptoms consistent with simple diagnosis, but are coming from an environment with the risk of Carbon Monoxide poisoning.

As I think of what that means, it means all situations, especially in the winter. So how could that practically be included in the standard medical diagnosis: Would it be so hard to start all inquiries with: do you have a carbon monoxide detector in your living space? In some places like Chicago, it is the law.

1 reply
  1. Hilary
    Hilary says:

    There is an opinion that a fatal heart attack may occur some time after carbon monoxide exposure. My 48 year old’s husband’s blood pressure in mid June 2007 was “like a teenager’s” he was exposed to a very high level of carbon monoxide one month later, a dose he was told would have killed 98% of people, he died in February 2008 of a ‘silent’ heart attack with stenotic artery and plaque in the cerebral artery, following increasing tiredness that he put down to his workload. A retired forensic pathologist and family friend remarked that his blood pressure must have been sky high for some considerable time. If someone is collecting statistics on post carbon monoxide poisoning heart deaths I would like this case added to the list


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