Evidence of myocardial ischaemia in severe scorpion envenomation

Bahloul, Mabrouk; Hamida, Chokri Ben; Chtourou, K.; Ksibi, Hichem; Dammak, Hassen; Kallel, Hatem; Chaari, Adel; Chelly, Hédi; Guermazi, F.; Rekik, Noureddine; Bouaziz, Mounir

doi:10.1007/s00134-003-2082-7

Cited by 62 publications

(70 citation statements)

References 19 publications

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“…The results obtained in the present study corroborate some of Bahoul et al 13 initial observations and add other important information, especially regarding recovery of perfusion and function abnormalities in the short term after envenomation.…”

Section: Discussionsupporting

confidence: 92%

“…In Bahloul et al's study 13 , six patients with signs of left ventricular dysfunction following scorpion envenomation underwent 201 Tl myocardial perfusion scintigraphy within 12 to 17 hours of the event. Myocardial perfusion defects were observed in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…The participation of myocardial ischemia in the pathophysiology of scorpion envenomation in humans has been suggested in few clinical studies [11][12][13] . In a previous report, we demonstrated the presence of severe transient alterations of the myocardial perfusion in victims of severe scorpion envenomation 14 .…”

Section: Introductionmentioning

confidence: 99%

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Avaliação da perfusão e função miocárdicas em vítimas de escorpionismo utilizando o Gated-SPECT

Figueiredo¹,

Cupo²,

Pintya³

et al. 2010

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Avaliação da perfusão e função miocárdicas em vítimas de escorpionismo utilizando o Gated-SPECT

Figueiredo¹,

Cupo²,

Pintya³

et al. 2010

Arq. Bras. Cardiol.

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“…These changes regressed after 72h. Bahloul et al (43) later described perfusion changes compatible with LV dysfunction in 6 patients (3 children and 3 adults) 12-74h after Androctonus australis envenoming; these changes also correlated with ECHO fi ndings. Exams repeated after 6 and 15 days in two patients showed partial regression of these fi ndings.…”

Section: Complications Of Scorpion Envenomingmentioning

confidence: 89%

Clinical update on scorpion envenoming

Cupo

2015

Rev. Soc. Bras. Med. Trop.

110

126

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Scorpion stings are currently the leading cause of venom-related injury to humans in Brazil and are a signifi cant public health problem globally. Only scorpions of the Tityus genus are of medical importance in Brazil, and Tityus serrulatus is responsible for the most serious envenomations and deaths. The toxic effects of scorpion envenomation are due to a massive release of sympathetic and parasympathetic neurotransmitters; the severity is related to cardiac and hemodynamic changes, with cardiogenic shock and pulmonary edema contributing to the main causes of death. The pathophysiology of cardiac involvement has been discussed for decades and has been attributed to adrenergic discharge and a possible toxic effect of venom on the myocardium, while acute pulmonary edema may have a cardiogenic and/or non-cardiogenic origin. Currently, the clinical data point to catecholamine excess as the cause for reversible scorpion cardiomyopathy. These data include electrocardiographic changes, profi ling of cardiac enzymes and troponin I, echocardiographic data with global or regional left ventricle dysfunction, and myocardial perfusion alterations compatible with spasm in the coronary microcirculation. Furthermore, recent data on cardiac magnetic resonance imaging fi ndings, which are similar to those observed for stress-induced cardiomyopathy, have also been linked to catecholamine excess. The effi ciency of antivenom serum treatment is controversial in the literature. Our experience in Brazil is that the management of patients with systemic manifestations of scorpion stings is based on three approaches, all of which are extremely important. These include symptomatic treatment, antivenom serum, and cardiorespiratory support.

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“…[2][3][4][5] Moreover, we have postulated that in many of these cases, the patients were stung because of careless behaviour such as walking bare foot. We have never previously encountered scorpion envenomation during hospital stay.…”

mentioning

confidence: 99%