Sulfur Mustard Exposure and Cardiovascular Effects: A Review




Sulfur mustard (SM) has been used as a chemical weapon in some conflicts, and many veterans and civilians have been injured thereby. Pulmonary, cutaneous, and ocular effects of SM have been frequently reported, although it seems that other organs such as the cardiovascular system are probably also affected. There are a number of studies evaluating the cardiovascular impacts of SM. However, these are dispersed and unfocused. In this paper, these studies have been reviewed to draw conclusions about the cardiovascular effects of SM. It seems that there is a probable relationship between SM exposure and cardiovascular toxicity in the long term. It appears that coronary artery diseases especially coronary ectasia and diastolic dysfunction are among the significant cardiovascular abnormalities frequently seen in these patients. Abnormal coronary arteries may occur due to direct endothelial injury by SM, sustained inflammatory status in patients with chronic lung disease, and abnormal mediators of tissue injury and repair or oxidative stressors.