LETTER TO THE EDITOR: Reply to: First degree AV block due to carbon monoxide or cyanide poisoning. Which of them?

Thank you Dr. Sanaei-Zadeh for the letter and we welcome the opportunity to clarify few points as below. Smoke inhalation is a common cause of Cyanide poisoning during fires, resulting in injury and even death. The diagnosis of cyanide poisoning remains very difficult and requires high index of suspicion based on history and clinical presentation [1]. In our case [2] cyanide poisoning does not fit the complete picture of cyanide poisoning, in which the victim will have a bitter, almond odor [3], which was not noticed in our patient.