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Research Article | Volume 13 Issue:1 (, 2023) | Pages 1457 - 1461
Cardiac Profile in Patients with Snake Envenomation and Its Complications: An Observational Study
Under a Creative Commons license
Open Access
DOI : 10.5083/ejcm
Published
March 31, 2023
Abstract

Background: Snakebite envenomation represents a prevalent and acute medical emergency of significant mortality in the Indian context. Farmers and agricultural labourers are the individuals who face the highest level of risk. Individuals employed in occupations such as bush cleaners, construction workers, scientists, and entertainers who come into contact with snakes face an elevated level of risk. Snakebite primarily affects individuals in rural areas and is commonly encountered as an occupational hazard among farmers and land workers. The timely administration of treatment can effectively address snake bites. The objective of this study was to assess the impact of snake envenomation on the cardiovascular profile. Method: This prospective observational study included a total of 200 patients, all of whom were over the age of 14 and had been diagnosed with snake bite. Patients with pre-existing conditions such as ischemic heart disease, diabetes, valvular heart disease, known history of cardiomyopathy, and deep vein thrombosis were excluded from the study. All individuals were subjected to a comprehensive assessment, including a physical examination, electrocardiogram, echo-cardiography, arterio-venous colour doppler study, and analysis of cardiac enzymes. Result: Total 200 cases had envenomation. Most common ECG manifestation showed sinus tachycardia 65% followed by 25% patients have normal ECG finding, 12% ST-T changes due to myocardial injury, 7% had bradycardia only 2% patients have noted A-V block.8).7Most of the echocardiographic findings are normal. Only 9% patients have global hypokinesia. Increase CPK-MB level seen in 5% cases. Increased troponin-I level seen in 12% cases. Conclusion: Cardiac complications are not commonly observed manifestations of snake bites, as the clinical presentation is typically characterised by predominant neurological, haematological, and vascular impairments caused by the snake venom. The predominant cardiac manifestation observed in electrocardiograms (ECGs) was sinus tachycardia, which could potentially be attributed to anxiety. This was closely followed by sinus bradycardia. Several patients exhibited myocarditic changes that were identified through consecutive electrocardiograms (ECGs). The elevation of CPK-MB levels has been observed in approximately 5% of cases. A 12% incidence of elevated troponin-I levels was observed. The prevailing echocardiographic observation indicated the presence of global hypokinesia.

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