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Ventricular bigeminy following a cobra envenomation

Ahmad Khaldun Ismail1, Scott A Weinstein, Mark Auliya

  • 1Department of Emergency Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia. khaldun_ismail@yahoo.com

Clinical Toxicology (Philadelphia, Pa.)
|June 19, 2012
PubMed

Insights

Cobra envenomation can cause cardiotoxicity, leading to ventricular bigeminy. Prompt antivenom treatment resolved this dangerous heart rhythm in a documented case.

Area of Science:

  • Cardiology
  • Toxicology
  • Herpetology

Background:

  • Naja species cobra envenomation can cause cardiotoxicity and dysrhythmias.
  • Ventricular bigeminy has not been previously documented as a consequence of cobra bites.

Observation:

  • A 23-year-old male presented with symptoms following a suspected cobra bite, including nausea, vomiting, hypotension, and tachycardia.
  • Electrocardiogram (ECG) revealed ventricular ectopics progressing to ventricular bigeminy, persisting despite normalized vital signs.

Findings:

  • Monovalent antivenom against Naja kaouthia venom administration led to complete resolution of ventricular bigeminy.
  • Normal sinus rhythm was restored, and the patient was discharged after observation.

Implications:

  • This case highlights ventricular bigeminy as a potential complication of Naja spp. envenomation.
  • Emphasizes the importance of thorough clinical evaluation, serial monitoring of vital signs, and early cardiac monitoring in managing cobra bites.
Abstract

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