Electrocardiographic abnormalities in patients bitten by taipans (Oxyuranus scutellatus canni) and other elapid snakes in Papua New Guinea.
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| Abstract |
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.
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| 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 |
| Journal | Transactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) 1997 Jan-Feb Vol. 91 Issue 1 Pg. 53-6 ISSN: 0035-9203 [Print] England |
| PMID | 9093629 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't) |
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