A Study of Cardiac Profile in Patients with Snake Envenomation and Its Complications

Abstract

Background: Snake bite is a common and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. The present study was undertaken to evaluate the effect on cardiac profile in patients with snake envenomation and its complications. Methods: A total of 200 patients with snake envenomation were enrolled in this study excluding patients having history of any cardiovascular disease, renal disease, coagulopathy, liver disease, neuromuscular disease and those cases who bitten by non-poisonous snakes. All patients underwent physical examination, laboratory, Electrocardiogram (ECG), X-ray of chest and echocardiogram investigations. Results: A total of 200 cases had envenomation having 116 (58%) of male subjects. Most common local signs were edema 187 (93.5%), tenderness 141 (70.5%), skin necrosis 81 (40.5%) and blistering 12 (6%). Severity of local envenomation was graded into mild 66 (33%), moderate 120 (60%) and severe 14 (7%) cases. Systemic manifestations were present in 83 patients of venomous bites. It includes that majorly 53 (26.5%) cases had vomiting, 44 (22%) cases had abdominal pain and 9 (4.5%) cases of hypotension. ECG manifestation showed 27 (13.5%), 6 (3%) and 1 (0.5%) patients had sinus tachycardia, sinus bradycardia and ventricular tachycardia respectively. While, 9 (4.5%) cases had T inversion alone in precordial leads. Mortality (3%) was observed in intracranial bleed, neurotoxicity and capillary leak syndrome. However, cardiovascular involvement was not responsible for mortality in any cases. Conclusion: In conclusion, ventricular tachycardia is one of the manifestations of snake envenomation. Moreover, sinus tachycardia is common cardiovascular sign which may not be due to cardiac causes. Mortality results conclude that, cardiovascular involvement could not be responsible for mortality in snake envenomation.