# From Rust to Rhythm: A Case of Toxin-Induced Junctional Bradycardia

## TL;DR

A 68-year-old man developed a slow heart rate after inhaling a rust-prevention chemical and recovered fully with treatment.

## Contribution

This is the first reported case linking POR-15 solution inhalation to junctional bradycardia.

## Key findings

- Inhalation of POR-15 can cause junctional bradycardia requiring isoprenaline infusion.
- The patient recovered fully without needing a pacemaker or long-term follow-up.
- Inhalation exposure should be considered in cases of unexplained arrhythmias.

## Abstract

We present a case of a 68-year-old gentleman who developed acute symptomatic junctional bradycardia secondary to inhalation of Paint-Over-Rust 15 solution (POR-15), an anti-rust agent commonly used in both occupational and home environments. Management of this case included the use of isoprenaline infusion and close monitoring at a cardiac center for eight days. The patient made a full recovery with complete resolution of the symptoms without the need for a permanent pacemaker and further cardiology follow-up. Although rare, this case highlights the importance of considering inhalation exposure in patients presenting with arrhythmias, as this is often under-recognized in clinical practice. It also highlights the importance of appropriate cardiac monitoring and the early involvement of specialist centers. To our knowledge, this is the first reported case directly related to POR-15 solution.