Troponin elevation after black widow spider envenomation

Area of Science:

• Toxicology
• Cardiology
• Emergency Medicine

Background:

• Black widow spider envenomation typically causes localized pain, manageable with standard emergency department treatments.
• Severe complications, though uncommon, may necessitate admission or antivenom therapy.

Observation:

• An 84-year-old male presented with chest pain and dyspnea following a western black widow spider bite.
• Initial cardiac troponin I levels were elevated, peaking at 0.17 ng/ml, indicating potential myocardial injury.
• The patient also developed rhabdomyolysis, an unusual complication of black widow envenomation.

Findings:

• Elevated cardiac biomarkers, such as troponin I, are rarely reported in black widow spider envenomation.
• This case demonstrates a rare presentation of western black widow spider bite with cardiac involvement and rhabdomyolysis.
• The study discusses potential causes for elevated cardiac biomarkers in this context.

Implications:

• Clinicians should consider rare cardiac complications in patients presenting with symptoms after black widow spider bites.
• Prompt recognition and management of severe envenomation symptoms, including cardiac biomarkers and rhabdomyolysis, are crucial.
• Further research into the cardiovascular effects of black widow spider venom is warranted.