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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
Summary
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.
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