Myocardial Infarction after Snake Bite

Gomes, Rafael Alessandro Ferreira; Cantarelli, Fabiano; Vieira, Franklin Almeida; Jr., Aluisio Roberto Andrade Macedo; Gouveia, Milena Motta; Feitosa, Audes Diógenes de Magalhães

doi:10.5935/2359-4802.20170068

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“…Cardiac arrests are not prominent features of snakebite [43], whilst there are few clinical studies reporting that [44][45][46][47][48]. Although the venom mechanism of myocardial damage is not elucidated, it is known that increasing levels of blood potassium levels can be responsible for the cardiac arrest shortly after the bite [49].…”

Section: Discussionmentioning

confidence: 99%

Fatal Rattlesnake Envenomation in Northernmost Brazilian Amazon: A Case Report and Literature Overview

Medeiros

Oliveira

Ferreira

et al. 2020

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Snakebite envenomations are classified as Category A Neglected Tropical Diseases by the World Health Organization. In Brazil, 405 snake species are distributed among 11 families, with the genera Bothrops and Crotalus being the most studied and main responsible for severe and lethal envenomations. In the country, Crotalus genus (i.e., rattlesnakes) is represented by Crotalus durissus species, showing seven different subspecies distributed along the country, including Crotalus durissus ruruima, which inhabits Roraima, the Brazilian nothermost state from Amazon forest. Here, we report a fatal case of a severe envenomation following a rattlesnake bite. The patient presented classic crotalic neurological signs and symptoms such as ptosis, drooling of saliva, sluggishness, macroscopic hematuria, and oliguria, which evolved to acute kidney failure (AKF) and hemodynamic instability. Although the patient was treated with the specific antivenom therapy, the severe envenomation resulted in three cardiac arrests and death of the victim in less than 38 h. This study discusses the causes of the patient death, the features of rattlesnake venom-induced AKF, and shows evidences that the Brazilian crotalic antivenom should be improved to treat rattlesnake envenomations caused by C. d. ruruima venom in Roraima state.

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