Mistaken identity: Severe vomiting, bradycardia and hypotension after eating a wild herb

A 53-year-old woman presented with severe vomiting 3.5 hours after eating a boiled wild herb thought to be Hosta montana. She was alert, and did not complain of diplopia or numbness of her limbs. Her vital signs were temperature of 35.9°C, blood pressure of 84/33 mmHg, and heart rate of 59 beats/minute. There was no arrhythmia or conduction block on electrocardiogram. Her blood pressure and heart rate were decreased to 75/44 mmHg and 51 beats/minute at the minimum, respectively. Complete blood count and serum chemistry were normal. The herb was correctly identified when the patient's husband brought in the herb for identification.