Myocarditis along with acute ischaemic cerebellar, pontine and lacunar infarction following viper bite

Abstract

Cerebrovascular complications are rare following viper bites. A 65-year-old man presented with loss of consciousness and developed haemiparesis following a viper bite. Coagulation parameters were severely deranged. MRI showed acute ischaemic infarction on the left side in the precentral and postcentral gyrus, hemipons and cerebellum. Troponin T was elevated and transient left bundle branch block was seen. The patient had a good outcome following treatment with Anti Snake Venom and supportive therapy. Possible mechanisms of infarction are discussed.

Episodic Left Bundle Branch Block—A Comprehensive Review of the Literature

“…Episodic LBBB has been reported in several diverse clinical conditions. These are the following: coronary fistulas connecting main pulmonary artery with coronary arteries, chest trauma, cervical wound, Guillain‐Barre syndrome, takotsubo cardiomyopathy, Graves‐Basedow disease, hemorrhagic stroke, myocarditis in enteric fever, myocarditis along with acute ischemic cerebellar, pontine and lacunar infarction following viper bite, electroconvulsive therapy, endoscopic retrograde cholangiopancreatography, athletic heart syndrome, tachycardia induced cardiomyopathy, endoscopic brachytherapy for lung cancer, and propionic aciduria…”

Cardiac MRI-Proven Myocarditis Mimicking ST-Elevation Myocardial Infarction after a Cobra Bite

“…This is due to the direct cardiotoxic effect of the venom and hyperadrenergic state. Snake-venom-induced myocarditis has been reported in viper and krait envenomations with only a total of 2 definite and 1 probable reported cases worldwide [8-10] (Table 2). To our knowledge, this is the first reported case of myocarditis associated with cobra envenomation.…”

Bloqueo de rama intermitente revision de tema y abordaje de una entidad clinica compleja

“…Se ha informado bloqueo de rama cardiaco episódico en varias condiciones clínicas diversas. Estas son las siguientes: fístulas coronarias que conectan la arteria pulmonar principal con las arterias coronarias (Ito et al, 1998), (Juraschek et al, 2011), trauma torácico (Pizzo et al, 2005), (Ishikawa et al, 2014), síndrome de Guillain-Barr (Serrano Júnior et al, 1987), miocardiopatía de takotsubo (Di Cori et al, 2010), enfermedad de Graves-Basedow (Lubczynska-Kowalska et al, 1971), accidente cerebrovascular hemorrágico (Martynov et al, 2004), miocarditis en fiebre entérica (Prabha et al, 1995), miocarditis junto con infarto isquémico agudo cerebeloso, pontino y lacunar después de la mordedura de una víbora (Bhatt et al, 2013), terapia electroconvulsiva (D. A. Adams et al, 2014) colangiopancreatografía retrógrada endoscópica (Kounis et al, 2003), síndrome del corazón atlético (Chapman, 1977), miocardiopatía inducida por taquicardia (Senoo et al, 2014) y braquiterapia endoscópica para el cáncer de pulmón (Vasic et al, 2011).…”