Document Detail

Acute coronary ischemia following centipede envenomation: case report and review of the literature.
MedLine Citation:
PMID:  15228064     Owner:  NLM     Status:  MEDLINE    
This is the first known case report of electrocardiographic (ECG) changes suggestive of coronary vasospasm following a centipede envenomation. A 60-year-old man presented to the emergency department (ED) 1 hour after being stung by a 12-cm centipede. He complained of right great toe pain that did not radiate to his leg. The patient had no known ischemic heart disease. He did not describe any exertional symptoms but admitted experiencing weakness. During the ED course, concurrent with obtaining peripheral intravenous access, the patient experienced diaphoresis, dizziness, hypotension, and bradycardia. His ECG showed new ST-T wave changes, which suggested an acute ischemic process. The patient's blood pressure was 89/60 mm Hg, his pulse rate was 47 beats/min, and his respiration rate was 28 breaths/min. In the following hours, ECG findings returned to baseline. His blood pressure improved gradually with fluid resuscitation after approximately 5 hours. Cardiac markers returned to normal in the 13th hour after the event, and the patient underwent exercise stress testing, which was negative. The patient was discharged with cardiology follow-up. Adult patients with centipede envenomation should be closely monitored in anticipation of possible myocardial ischemia due to vasospasm, hypotension, and myocardial toxic effects of the venom. A child receiving the same amount of venom would be potentially at greater risk.
Murat Ozsarac; Ozgur Karcioglu; Cuneyt Ayrik; Fatih Somuncu; Serhat Gumrukcu
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Wilderness & environmental medicine     Volume:  15     ISSN:  1080-6032     ISO Abbreviation:  Wilderness Environ Med     Publication Date:  2004  
Date Detail:
Created Date:  2004-07-01     Completed Date:  2004-08-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9505185     Medline TA:  Wilderness Environ Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  109-12     Citation Subset:  IM    
Dokuz Eylul University School of Medicine, Department of Emergency Medicine, Inciralti, Izmir, Turkey.
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MeSH Terms
Arachnidism / complications,  diagnosis*,  therapy
Diagnosis, Differential
Emergency Treatment
Middle Aged
Myocardial Ischemia / complications,  diagnosis*,  therapy

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