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Haemodynamic patterns in patients with scorpion envenomation
1Department of Medicine, King Edward VII Memorial Hospital, Parel, Bombay, India.
Heart (British Cardiac Society)
|July 11, 1998
Summary
Indian red scorpion stings can cause severe cardiovascular issues. Severe envenomation leads to left ventricular dysfunction, manifesting as pulmonary edema or hypotension, while mild cases cause vasoconstriction and hypertension.
Area of Science:
- Cardiology
- Toxicology
- Intensive Care Medicine
Background:
- Scorpion envenomation is a significant health concern, particularly in tropical and subtropical regions.
- The cardiovascular effects of envenomation can range from mild to life-threatening.
Purpose of the Study:
- To investigate the cardiovascular hemodynamic changes in patients following Indian red scorpion (Mesobuthus tamulus) stings.
- To differentiate between vascular and myocardial effects of scorpion envenomation.
Main Methods:
- A study involving eight patients admitted to an intensive care unit after scorpion stings.
- Hemodynamic data were collected using pulmonary artery catheterization.
- Captopril was administered orally to manage pulmonary edema.
Main Results:
- Two distinct hemodynamic patterns were observed: one with predominant vascular effects (hypertension, tachycardia) and another with predominant myocardial effects (left ventricular dysfunction, pulmonary edema).
- Seven patients exhibited left ventricular dysfunction, leading to pulmonary edema or hypotension, influenced by fluid balance.
- One patient experienced fatal cardiogenic shock with biventricular dysfunction and vasodilation, while captopril improved hemodynamics in another.
Conclusions:
- Mild envenomation by the Indian red scorpion primarily causes vasoconstriction and hypertension.
- Severe envenomation typically results in left ventricular dysfunction, presenting as pulmonary edema or hypotension.
- Terminal shock can occur due to biventricular dysfunction and vasodilation.