Sarin cardiovascular effects

The committee concluded that there was inadequate or insufficient evidence to determine whether an association exists between exposure to sarin at doses which do not give rise to acute signs and symptoms and subsequent longterm neurological or cardiovascular effects. On present evidence, medically significant late sequelae of sarin exposure seem hard to prove (Sharp, 2006). 

Johnson, R. P., Gold, A. J., and Freeman, G, (1958), Comparative lung-airway resistance and cardiovascular effects in dogs and monkey.s following parathioii and sarin intoxication. Am. J. Physiol. 192, 581-584,... 

Well-known symptoms of sarin toxicity include miosis, hypersecretions, bradycardia, and fasciculations. However, the mechanism of organophosphate toxicity seems to involve conflicting actions. For example, mydriasis or miosis, and bradycardia or tachycardia may occur. Acute respiratory insufficiency is the most important cause of immediate death. Early symptoms include (i) tachypnea due to increased airway secretions and bronchospasm (a muscarinic effect), (ii) peripheral respiratory muscle paralysis (a nicotinic effect), and (iii) inhibition of respiratory centers (a CNS effect), all of which lead to severe respiratory deficiency. If left untreated at this stage, death will result. Cardiovascular symptoms may include hypertension or hypotension. Various arrhythmias can also occur, and caution is required when the QT interval is prolonged. In particular, if hypoxemia is present, fatal arrhythmias may occur with intravenous administration of atropine... 

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