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Evaluation of myocardial function using tissue Doppler imaging in children with moderate scorpion envenomation
1Department of Pediatric Cardiology, Baskent University Faculty of Medicine, Konya, Turkey. mgokdem@hotmail.com
Insights
Scorpion envenomation in children did not show significant myocardial dysfunction, except for sinus tachycardia. Early antivenom treatment may prevent cardiac issues in moderate cases.
Area of Science:
- Cardiology
- Pediatrics
- Toxicology
Background:
- Scorpion envenomation poses a significant public health risk, potentially causing severe respiratory, neurological, and cardiovascular complications.
- Children are disproportionately affected, exhibiting higher rates of systemic envenoming signs and mortality.
Purpose of the Study:
- To assess myocardial function in pediatric patients with moderate scorpion envenomation.
- Utilized pulsed tissue Doppler imaging (TDI) to evaluate cardiac performance.
Main Methods:
- Conducted a study in Turkey involving 30 children with moderate scorpion envenomation and 30 matched controls.
- Excluded severe and mild envenomation cases.
- Performed echocardiography and pulsed tissue Doppler imaging.
Main Results:
- A statistically significant increase in heart rate (sinus tachycardia) was observed in the envenomated group (33.3% of patients).
- Key echocardiographic parameters, including ejection fraction, fractional shortening, and myocardial performance index (MPI) of both ventricles, showed no significant differences between patients and controls.
- Specific measurements like isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) were also comparable.
Conclusions:
- Moderate scorpion envenomation in children, aside from sinus tachycardia, did not reveal considerable myocardial involvement.
- Prompt antivenom administration (within 4 hours) may be crucial in preventing cardiac dysfunction in these patients.
Context:
Scorpion envenomation is an important public health problem. It can cause life-threatening complications such as respiratory, neurological and cardiovascular compromise. Systemic envenoming signs and mortality rates are dramatically higher in children.
Objective:
The objective of this study was to evaluate myocardial function using pulsed tissue Doppler imaging in patients with moderate scorpion envenomation.
Materials And Methods:
The study was conducted from July to October 2009 in the South-East Anatolia region of Turkey. The study population consisted of 30 children with moderate scorpion envenomation and 30 age- and sex-matched normal controls. Severe and mild envenomations were excluded. In addition to echocardiographic examination, pulsed tissue Doppler imaging was performed.
Results:
The average age was 7.6 ± 4.3 years in patients and 7.9 ± 3.2 years in controls (p value, 0.77). The mean heart rate was 114 ± 19 beats/min (range, 72-164) in patients and 95 ± 14 beats/min (range, 72-127) in controls (p < 0.01). Sinus tachycardia (> 120 beats/min in children) was detected in ten (33.3%) patients. Myocardial performance index (MPI) was obtained with tissue Doppler imaging. The ejection fraction, the fractional shortening, the MPI of the left ventricle, the MPI of the right ventricle, the left ventricular isovolumetric contraction time (ICT), the left ventricular isovolumetric relaxation time (IRT), the left ventricular ejection time, the right ventricular ICT, the right ventricular IRT and the right ventricular ejection were not statistically different between the patients and the controls (p > 0.05).
Discussion:
We did not detect any considerable myocardial involvement in the children presenting with moderate scorpion envenomation except for sinus tachycardia. If the patients are treated with antivenom within 4 h, patients with moderate scorpion envenomation may not develop cardiac dysfunction.
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