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Published on: November 3, 2014
Myocarditis after black widow spider envenomation
Ibrahim Sari1, Suat Zengin, Vedat Davutoglu
1Department of Cardiology, Gaziantep University School of Medicine, Gaziantep TR-27310, Turkey. drisari@yahoo.com
The American Journal of Emergency Medicine
|June 7, 2008
Summary
Black widow spider (BWS) bites can cause rare cardiac issues. This case details myocarditis with ST-segment elevation following a BWS bite, emphasizing the need for cardiac monitoring.
Area of Science:
- Cardiology
- Toxicology
- Arthropod-borne Diseases
Background:
- Black widow spider (BWS) envenomation is common, but severe cardiovascular manifestations are rare.
- Typical BWS bite symptoms include hypertension/hypotension and bradycardia/tachycardia.
- Myocarditis is an exceptionally rare complication of BWS bites.
Observation:
- A 65-year-old man presented with chest pain after a BWS bite.
- Electrocardiography (ECG) revealed ST-segment elevation and T-wave augmentation.
- Cardiac enzyme levels (Creatine kinase-MB, troponin-I, aspartate aminotransferase) were significantly elevated.
Findings:
- This case represents the third report of myocarditis following BWS envenomation.
- It is the first documented case of ST-segment elevation and T-wave augmentation linked to BWS bites.
- The patient recovered fully with supportive care, with normalized ECG and cardiac enzymes.
Implications:
- BWS envenomation can lead to severe, potentially fatal cardiac complications.
- Routine ECG and cardiac enzyme monitoring are recommended for all BWS bite patients.
- Early detection and management of cardiac involvement are crucial for patient outcomes.
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