| Autor: |
Lalloo, David G., Trevett, Andrew J., Nwokolo, Nneka, Laurenson, Ian F., Naraqi, Sirus, Kevau, Isi, Kemp, Michael W., Hooper, R.James L., Theakston, R.David G., Warrell, David |
| Zdroj: |
Transactions of the Royal Society of Tropical Medicine & Hygiene; January 1997, Vol. 91 Issue: 1 p53-56, 4p |
| Abstrakt: |
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 (Acanthophissp.) 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. |
| Databáze: |
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