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Junctional bradycardia caused by ciguatera intoxication
Rajendra Raman1,2, Sarah Coppes2,3, Tessa Hellingman2,4
1Accident and Emergency, NHS Fife, Kirkcaldy, UK.
BMJ Case Reports
|June 2, 2019
Summary
Ciguatera poisoning, a tropical disease from contaminated fish, can cause unusual heart rhythm problems. This report details a rare case of junctional bradycardia linked to ciguatera in the Caribbean.
Area of Science:
- Tropical medicine
- Cardiology
- Environmental health
Background:
- Ciguatera is a prevalent tropical illness from consuming contaminated reef fish.
- Symptoms typically include gastrointestinal and neurological issues, but cardiovascular effects like hypotension and bradycardia can occur.
Observation:
- This study reports a unique case of junctional bradycardia attributed to ciguatera poisoning in the Caribbean.
- This is the first documented instance of such a cardiac manifestation in this region.
Findings:
- Ciguatera toxin exposure can lead to significant cardiovascular complications, including unusual bradyarrhythmias.
- The case highlights the diverse and sometimes atypical clinical presentations of ciguatera.
Implications:
- Rising sea temperatures may expand ciguatera's geographic range, increasing global health risks.
- Clinicians should consider ciguatera in the differential diagnosis of bradycardia, especially in patients with potential exposure.
- Global trade in seafood necessitates awareness of ciguatera beyond endemic areas.
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