Cardiac magnetic resonance study of scorpion toxic myocarditis

Lonati, Davide; Locatelli, Carlo; Sabri, Sherif; Moro, Guido; Catalano, Oronzo

doi:10.1093/qjmed/hcw210

Cited by 3 publications

(16 citation statements)

References 2 publications

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“…Ventricular tachycardia was another important finding [ 71 , 75 , 76 , 84 ]. Laboratory findings associated with myocarditis were raised levels of cardiac troponin T [ 49 , 57 , 61 , 64 , 70 , 72 , 75 , 87 ], troponin I [ 34 , 41 , 42 , 45 , 46 , 49 , 58 , 60 , 65 , 66 , 74 , 76 , 78 , 79 , 81 , 82 , 84 – 86 , 88 , 91 , 92 ], unspecified-type troponin [ 63 , 67 , 80 , 82 ], CK-MB [ 14 , 18 , 34 , 37 , 40 , 45 , 46 , 49 , 52 , 57 , 59 , 62 , 66 , 68 , 70 , 74 – 76 , <...…”

Section: Resultsmentioning

confidence: 99%

“…One study reported hemoglobin and plasma protein to be higher in patients with pulmonary edema [ 39 ]. Elevated serum glucose [ 26 , 34 , 37 , 38 , 41 , 47 , 61 , 62 , 65 , 66 , 72 , 73 , 84 , 85 , 87 ], amylase [ 37 , 38 , 44 , 47 , 62 , 81 , 84 , 87 ], creatinine phosphokinase [ 18 , 26 , 38 , 44 , 47 , 51 , 55 , 59 , 62 , 69 , 72 , 74 , 76 , 78 , 90 ], lactate dehydrogenase [ 55 , 78 , 81 , 89 , 90 ], alanine transaminase [ 73 , 83 , 86 , 87 ], aspartate transaminase [ 26 , 44 , 62 , 64 , 73 ,…”

Section: Resultsmentioning

confidence: 99%

“…Echocardiography findings in the studies included regional or global hypokinesia [ 13 , 26 , 34 , 36 – 38 , 45 , 48 , 51 , 52 , 54 , 57 , 59 , 61 , 62 , 67 , 71 , 72 , 75 – 77 , 79 , 81 , 83 – 87 , 90 , 91 ], chamber dilation [ 45 , 53 , 59 , 68 , 69 , 73 , 76 , 80 ], decreased left ventricular ejection fraction (LVEF) [ 13 , 14 , 18 , 26 , 34 , 36 – 41 , 45 , 46 , 48 , 49 , 51 – 55 , 57 – 75 , 77 – 93 ], decreased fractional shortening (FS) [ 37 , 38 , 41 , 48 , ...…”

Section: Resultsmentioning

confidence: 99%

“…Five studies investigated cardiac magnetic resonance (CMR) imaging in scorpion envenomation [ 63 , 67 , 75 , 81 , 85 ]. Enhancement of myocardium in T1-sequence and mild intramyocardial late enhancement (indicative of irreversible damage) were reported by Lonati et al [ 81 ]. Another study [ 75 ] reported global LV hypokinesia and impaired systolic function with diffuse myocardial edema.…”

Section: Resultsmentioning

confidence: 99%

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Scorpion envenomation-associated myocarditis: A systematic review

et al. 2023

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Background Scorpion envenomation is associated with several complications. One of the most serious complications is the cardiac involvement in the form of myocarditis that remains the main reason for mortalities associated with scorpion envenomation. The present review aims to elucidate clinical and paraclinical findings associated with scorpion-related myocarditis, and to explore different management strategies and subsequent outcomes. Methods We searched PubMed, Web of Science, Scopus, and Google Scholar for articles related to keywords of myocarditis associated with scorpion envenomation up to May 1, 2022. Each article was carefully reviewed by two independent researchers. In case of disagreement for inclusion, we sought a third researcher opinion. Results A total of 703 cases from 30 case reports and 34 case series were included in our review. Myocarditis associated with scorpion envenomation was usually reported in children presenting with cardiopulmonary symptoms including pulmonary edema (60.7%) and shock or hypotension (45.8%). The most common ECG findings are sinus tachycardia (82%) followed by ST-T changes (64.6%). The management typically included inotropes (especially dobutamine), prazosin, diuretics, nitroglycerine and digoxin, when indicated. Mechanical ventilation was required in 36.7% of the patients. Mortality in confirmed scorpion-related myocarditis cases is estimated at 7.3%. Almost all survived cases showed rapid recovery and improvement in the left ventricular function. Conclusion Even though myocarditis associated with scorpion envenomation is rare, it remains a serious and in some of cases a fatal consequence of scorpion sting. In case of relative presentations, particularly in envenomed children, diagnosis of myocarditis should be considered. Early screening using serial cardiac markers and echocardiography can guide the treatment. Prompt treatment that focuses on cardiogenic shock and pulmonary edema usually results in a favorable outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Scorpion envenomation-associated myocarditis: A systematic review

et al. 2023

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“…CMR imaging is also useful for confirming recovery, as in the present case, and especially for detection of irreversible myocardial damage and dilated cardiomyopathy delayed development. 3,11…”

Section: Discussionmentioning

confidence: 99%

Severe acute myocarditis due to scorpion envenoming: unusual presentation in adults

Sá¹,

Vale²,

Oliveira³

2020

JCCR

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A 21-year-old healthy woman presented to emergency department complaining of severe gluteus pain and progressive dyspnea about one hour after domestic accidental "black scorpion" sting. Despite early scorpion antivenom administration, advanced airway and intensive critical care were promptly required, due to refractory acute respiratory failure (ARF), endorsed by a critical PaO2/ FiO2 of 48. Chest computed tomography revealed diffuse bilateral infiltrates and air bronchograms compatible with acute respiratory distress syndrome. Cardiac troponin levels continuously rose. Initial transthoracic echocardiogram (TTE) revealed diffuse hypokinesia causing moderate left ventricle (LV) systolic dysfunction -rest LV ejection fraction (LVEF) of 0.39 (Simpson´s method) (Figure 1). Inotrope at low doses (dobutamine 5mcg/kg/min) was then initiated. Follow-up (ninth day) TTE (Figure 2) and cardiac magnetic resonance (CMR) imaging endorsed reversal of initial contractile dysfunction. At eleventh day patient was uneventfully discharged home.

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Cardiac MRI Evaluation of Myocarditis

Hahn

Kligerman

2019

Curr Treat Options Cardio Med

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Cardiac magnetic resonance study of scorpion toxic myocarditis

Cited by 3 publications

References 2 publications

Scorpion envenomation-associated myocarditis: A systematic review

Scorpion envenomation-associated myocarditis: A systematic review

Severe acute myocarditis due to scorpion envenoming: unusual presentation in adults

Cardiac MRI Evaluation of Myocarditis

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