Document Detail


Ventricular bigeminy following a cobra envenomation.
MedLine Citation:
PMID:  22702902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Envenoming by some species of cobras (Naja species) may include cardiotoxic effects including various dysrhythmias. However, dysrhythmias leading specifically to ventricular bigeminy have not been previously documented. We report a case of cardiotoxicity and the development of ventricular bigeminy following a cobra envenomation.
CASE DETAILS: The patient was a 23-year-old man who presented to an emergency department following an alleged cobra bite. There was transient episode of nausea, vomiting, hypotension and tachycardia. The ECG showed infrequent ventricular ectopics that progressed to ventricular bigeminy and persisted even after the vital signs normalized. Complete resolution and resumption of normal sinus rhythm occurred following an empirical administration of monovalent antivenom against Naja kaouthia venom. The patient was discharged after 24 hours of uneventful observation.
DISCUSSION: The patient's concomitant local effects, episodic cardiovascular instability and evolution of ventricular bigeminy support the likelihood of a venom-induced disease. Ventricular bigeminy can develop following a cobra envenomation. Thorough clinical evaluation, close serial observation of vital signs and early continuous cardiac monitoring are important in Naja spp. bites.
Authors:
Ahmad Khaldun Ismail; Scott A Weinstein; Mark Auliya; Prakashrao Appareo
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-06-18
Journal Detail:
Title:  Clinical toxicology (Philadelphia, Pa.)     Volume:  50     ISSN:  1556-9519     ISO Abbreviation:  Clin Toxicol (Phila)     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-09-06     Revised Date:  2012-12-12    
Medline Journal Info:
Nlm Unique ID:  101241654     Medline TA:  Clin Toxicol (Phila)     Country:  England    
Other Details:
Languages:  eng     Pagination:  518-21     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia. khaldun_ismail@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Cobra Venoms / toxicity*
Electrocardiography
Humans
Male
Snake Bites / complications*
Ventricular Premature Complexes / etiology*
Chemical
Reg. No./Substance:
0/Cobra Venoms
Comments/Corrections
Comment In:
Clin Toxicol (Phila). 2012 Nov;50(9):862; author reply 863   [PMID:  22909261 ]

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


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