A Review on Arrhythmias due to Snakebite
DOI:
https://doi.org/10.37506/qcxvtn85Keywords:
snakebite, envenomation , arrhythmiaAbstract
An estimated 1.8 to 2.5 million venomous snakebites occurworldwide each year and result in at least 100,000 to 125,000deaths. It is a public health problem particularly in tropical and subtropical regions. It is known that 4 species of snakes(Viperidae, Elapidae, Colubridae, and Lamprophiidae) are determined to cause harm to humans. Envenoming by these snake species may cause myocardial damage and electrocardiographic deterioration. Common manifestations of cardiovascular toxicity are acute myocardial infarction, electrocardiogramabnormalities and arrhythmias. In this narrative review, we aimed to conduct a comprehensive analysis of cardiovascular toxicity due to snake bite.
References
Agarwal R, Singh AP, Aggarwal AN. Pulmonary oedema complicating snake bite due to Bungarus caeruleus. Singapore Med J. 2007;48(8):e227-e230.
White J. Venomous animals: clinical toxinology. EXS. 2010;100:233-291. doi:10.1007/978-3-7643-8338-1_7
Liblik K, Byun J, Saldarriaga C, et al. Snakebite Envenomation and Heart: Systematic Review. Curr Probl Cardiol. 2022;47(9):100861. doi:10.1016/j.cpcardiol.2021.100861
Lalloo DG, Trevett AJ, Nwokolo N, et al. Electrocardiographic abnormalities in patients bitten by taipans (Oxyuranus scutellatus canni) and other elapid snakes in Papua New Guinea. Trans R Soc Trop Med Hyg. 1997;91(1):53-56. doi:10.1016/s0035-9203(97)90394-1
Quan D, Zurcher K. Reversible atrial fibrillation following Crotalinae envenomation. J Venom Anim Toxins Incl Trop Dis. 2017;23:16. Published 2017 Mar 21. doi:10.1186/s40409-017-0108-9
Gawarammana IB, Kularatne SA, Dissanayake WP, Kumarasiri RP, Senanayake N, Ariyasena H. Parallel infusion of hydrocortisone +/- chlorpheniramine bolus injection to prevent acute adverse reactions to antivenom for snakebites [published correction appears in Med J Aust. 2004 Apr 19;180(8):428]. Med J Aust. 2004;180(1):20-23. doi:10.5694/j.1326-5377.2004.tb05768.x
Agarwal A, Kumar T, Ravindranath KS, Bhat P, Manjunath CN, Agarwal N. Sinus node dysfunction complicating viper bite. Asian Cardiovasc Thorac Ann. 2015;23(2):212-214. doi:10.1177/0218492313501819
Khaldy M, Arafat H, Khaldi Y. Atrial fibrillation caused by Daboia palestinae snakebite: a case report. Oxf Med Case Reports. 2023;2023(12):omad136. Published 2023 Dec 19. doi:10.1093/omcr/omad136
Hafeez S, Majeed I. Cardiac arrhythmia as presentation of snakebite. J Coll Physicians Surg Pak. 2004;14(1):48-49.
Senthilkumaran S, Meenakshisundaram R, Thirumalaikolundusubramanian P, Menezes RG. Cardiac toxicity following cobra envenomation. Clin Toxicol (Phila). 2012;50(9):862-863. doi:10.3109/15563650.2012.720261
Thewjitcharoen Y, Poopitaya S. Ventricular tachycardia, a rare manifestation of Russell's viper bite: case report. J Med Assoc Thai. 2005;88(12):1931-1933.
Athapathu AS, Arunath V, Aruppala AA, Hoole TJ, Suntharesan K, Mettananda S. Delayed-onset sinus node dysfunction in a child victim of Russell's viper bite. Asian Cardiovasc Thorac Ann. 2020;28(4):213-215. doi:10.1177/0218492320919636
Than-Than, Francis N, Tin-Nu-Swe, et al. Contribution of focal haemorrhage and microvascular fibrin deposition to fatal envenoming by Russell's viper (Vipera russelli siamensis) in Burma. Acta Trop. 1989;46(1):23-38. doi:10.1016/0001-706x(89)90013-2
Magdalan J, Trocha M, Merwid-Lad A, Sozański T, Zawadzki M. Vipera berus bites in the Region of Southwest Poland--a clinical analysis of 26 cases. Wilderness Environ Med. 2010;21(2):114-119. doi:10.1016/j.wem.2010.01.005
Moore RS. Second-degree heart block associated with envenomation by Vipera berus. Arch Emerg Med. 1988;5(2):116-118. doi:10.1136/emj.5.2.116
Hønge BL, Hedegaard SK, Cederstrøm S, Nielsen H. Hospital contacts after bite by the European adder (Vipera berus). Dan Med J. 2015;62(3):A5022.
Marinov I, Atanasov VN, Stankova E, Duhalov D, Petrova S, Hubenova A. Severe coagulopathy after Vipera ammodytes ammodytes snakebite in Bulgaria: a case report. Toxicon. 2010;56(6):1066-1069. doi:10.1016/j.toxicon.2010.06.010
Nayak KC, Jain AK, Sharda DP, Mishra SN. Profile of cardiac complications of snake bite. Indian Heart J. 1990;42(3):185-188.
Namal Rathnayaka RMMK, Nishanthi Ranathunga PEA, Ranaweera J, Jayasekara K, Kularatne SAM. Cardiac arrest and atrial fibrillation in a patient after hump-nosed pit viper (Hypnale hypnale) bite. Toxicon. 2018;148:33-39. doi:10.1016/j.toxicon.2018.03.014
Thillainathan S, Priyangika D, Marasinghe I, Kanapathippillai K, Premawansa G. Rare cardiac sequelae of a hump-nosed viper bite. BMC Res Notes. 2015;8:437. Published 2015 Sep 14. doi:10.1186/s13104-015-1426-z
Choo KH, Adnan AB, Ismail AK. Multiple ventricular premature complexes following equatorial spitting cobra (Naja sumatrana) envenomation. Toxicon. 2024;250:108099. doi:10.1016/j.toxicon.2024.108099
Ismail AK, Weinstein SA, Auliya M, Appareo P. Ventricular bigeminy following a cobra envenomation. Clin Toxicol (Phila). 2012;50(6):518-521. doi:10.3109/15563650.2012.696119
Amri K, Chippaux JP. Report of a severe Heloderma suspectum envenomation. Clin Toxicol (Phila). 2021;59(4):343-346. doi:10.1080/15563650.2020.1804574
Bawaskar HS, Bawaskar PH. Envenoming by scorpions and snakes (Elapidae), their neurotoxins and therapeutics. Trop Doct. 2000;30(1):23-25. doi:10.1177/004947550003000112
Kim OH, Lee JW, Kim HI, et al. Adverse Cardiovascular Events after a Venomous Snakebite in Korea. Yonsei Med J. 2016;57(2):512-517. doi:10.3349/ymj.2016.57.2.512
Buckley N, Dawson AH. Unusual results of brown snake envenomation. Med J Aust. 1993;158(12):866-868. doi:10.5694/j.1326-5377.1993.tb137686.x
Warrell DA, Ormerod LD, Davidson NM. Bites by puff-adder (Bitis arietans) in Nigeria, and value of antivenom. Br Med J. 1975;4(5998):697-700. doi:10.1136/bmj.4.5998.697
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