Document Detail


Electrocardiographic abnormalities in patients bitten by taipans (Oxyuranus scutellatus canni) and other elapid snakes in Papua New Guinea.
MedLine Citation:
PMID:  9093629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Envenoming by a number of species of snake may affect the myocardium or cause electrocardiographic changes; several different mechanisms have been proposed. In a prospective study of snake bite in Papua New Guinea, electrocardiographic changes were observed in 36 of 69 patients (52%) envenomed by the taipan (Oxyuranus scutellatus), 2 of 6 (33%) envenomed by death adders (Acanthophis sp.) and one envenomed by the brown snake (Pseudonaja textilis). Septal T wave inversion and bradycardias, including atrioventricular block, were the commonest abnormalities. There was no haemodynamic deterioration. The cause of these changes is uncertain; only 2 of 24 patients (8.3%) with electrocardiographic changes had markedly elevated plasma concentrations of cardiac troponin T, a sensitive and specific marker of myocardial damage. This suggests that myocardial damage is uncommon following bites by these species. Electrocardiographic abnormalities are most likely to have been caused by a direct toxic effect of a venom component upon cardiac myocyte function; in taipan bites, taicatoxin, a calcium channel blocker, might be responsible.
Authors:
D G Lalloo; A J Trevett; N Nwokolo; I F Laurenson; S Naraqi; I Kevau; M W Kemp; R James; L Hooper; R David; G Theakston; D Warrell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transactions of the Royal Society of Tropical Medicine and Hygiene     Volume:  91     ISSN:  0035-9203     ISO Abbreviation:  Trans. R. Soc. Trop. Med. Hyg.     Publication Date:    1997 Jan-Feb
Date Detail:
Created Date:  1997-04-17     Completed Date:  1997-04-17     Revised Date:  2009-09-29    
Medline Journal Info:
Nlm Unique ID:  7506129     Medline TA:  Trans R Soc Trop Med Hyg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  53-6     Citation Subset:  IM    
Affiliation:
Centre for Tropical Medicine, John Radcliffe Hospital, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Coagulation Disorders / physiopathology
Bradycardia / physiopathology
Cardiomyopathies / blood,  etiology,  physiopathology*
Creatine Kinase / blood
Elapid Venoms / poisoning*
Elapidae*
Electrocardiography
Hemodynamics
Humans
Myocardium / metabolism
Papua New Guinea
Prospective Studies
Snake Bites / blood,  complications,  physiopathology*
Troponin / blood
Troponin T
Grant Support
ID/Acronym/Agency:
//Wellcome Trust
Chemical
Reg. No./Substance:
0/Elapid Venoms; 0/Troponin; 0/Troponin T; EC 2.7.3.2/Creatine Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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