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Mohave Rattlesnake Envenomation Causing Allergic Myocardial Infarction (Kounis Syndrome) and Neurotoxic Respiratory
Martina Mookadam1, Damir Vukomanovic2, Siamac Yazdchi3
1Department of Family Medicine, Mayo Clinic, Scottsdale, AZ.
Wilderness & Environmental Medicine
|February 14, 2025
Summary
Mohave rattlesnake venom (Crotalus scutulatus) can cause Kounis syndrome, a rare allergic heart attack. This case also involved unique respiratory failure from diaphragmatic paralysis.
Area of Science:
- Toxicology
- Cardiology
- Neurology
Background:
- Mohave rattlesnakes (Crotalus scutulatus) inhabit southwestern US deserts and southern Mexico.
- Their venom causes local and systemic effects, including neurotoxicity.
- Kounis syndrome is an allergic reaction causing myocardial injury.
Observation:
- A patient envenomated by C. scutulatus developed Kounis syndrome presenting as allergic myocardial infarction.
- The patient also experienced respiratory failure due to right hemidiaphragmatic paralysis.
- Severe neurotoxicity from Mohave rattlesnake bites is rarely reported.
Findings:
- This is the first reported case associating C. scutulatus envenomation with Kounis syndrome.
- The patient's presentation included both allergic myocardial infarction and diaphragmatic paralysis.
- The venom's protein complex likely influenced the specific clinical manifestations.
Implications:
- Highlights a novel association between rattlesnake envenomation and cardiac events.
- Suggests a broader spectrum of C. scutulatus venom toxicity than previously understood.
- Underscores the importance of considering Kounis syndrome in venomous snakebite victims.
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