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Snakebite Envenomation and Heart: Systematic Review
Kiera Liblik1, Jin Byun2, Clara Saldarriaga3
1Department of Medicine, Kingston Health Science Center, Queen's University, Kingston, Ontario, Canada.
Insights
Snakebite envenomation can cause serious cardiac issues, including heart attack and arrest. Early screening using ECGs is vital for patients with systemic illness after a snakebite.
Area of Science:
- Cardiology
- Toxicology
- Tropical Medicine
Background:
- Snakebite envenomation is a neglected tropical disease with significant morbidity and mortality.
- Cardiovascular implications of snakebites are not well understood due to infrequent cardiotoxicity and limited data from remote areas.
Purpose of the Study:
- To review cardiovascular manifestations of snakebite envenomation.
- To propose a screening algorithm for cardiac complications.
Main Methods:
- A systematic review of 29 articles concerning cardiovascular involvement in snakebite envenomation was conducted.
Main Results:
- Cardiovascular involvement in snakebites is rare but diverse, including myocardial infarction, ventricular dysfunction, hypotension, cardiac arrest, and myocarditis.
- A significant percentage (24.39%) of cases with cardiovascular manifestations experienced severe outcomes like cardiac arrest, myocardial infarction, malignant arrhythmias, or death.
Conclusions:
- Early detection of cardiovascular involvement is crucial.
- Clinical monitoring, physical examination, and electrocardiogram (ECG) are key for identifying cardiac issues in patients with systemic illness following snakebite.
Abstract:
Snakebite envenomation is a neglected tropical disease which can result in morbidity and mortality. Cardiac implications are poorly understood due to the low frequency of cardiotoxicity combined with a lack of robust information, as snakebites commonly occur in remote and rural areas. This review aims to assess cardiovascular implications of snakebite envenoming and proposes an algorithm for screening of cardiovascular manifestations. A systematic review was performed and 29 articles relating to cardiovascular involvement in snakebite envenomation were selected. Cardiovascular involvement seems to be rare and includes a wide spectrum of outcomes, such as myocardial infarction, ventricular dysfunction, hypotension, cardiac arrest, and myocarditis. In a significant proportion of the cases analyzed (24.39%), the cardiovascular manifestations had major consequences (cardiac arrest, myocardial infarction, malignant ventricular arrhythmias, or death). Clinical monitoring, physical examination, and early electrocardiogram should be considered as key measures to detect cardiovascular involvement in patients with evidence of systemic illness.
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