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Cardiac Dysfunction and Pulmonary Edema following Scorpion Envenomation

1991; Elsevier BV; Volume: 100; Issue: 4 Linguagem: Inglês

10.1378/chest.100.4.1057

1931-3543

Fekri Abroug, R. Boujdaria, M. Belghith, Semir Nouira, Slah Bouchoucha,

Cardiac electrophysiology and arrhythmias

Cardiac dysfunction with pulmonary edema following scorpion envenomation (SE) has been documented only in a few isolated case reports. We conducted a systematic hemodynamic study in five consecutive patients (mean age, 21.6±8 years) presenting with pulmonary edema occurring a few hours (9.6±5.2 hours) after SE. All patients had increased pulmonary capillary wedge pressure (mean, 25±1.8 mm Hg) while the systemic vascular resistance was elevated only in one. The stroke volume index was markedly depressed (21.7±3.6 ml/sq m) whereas cardiac index was normal or slightly decreased (2.5±0.4 L/min/sq m). Cerebral infarct and sudden cardiac arrest were the cause of death in two patients. In the three survivors, all the hemodynamic disturbances and respiratory abnormalities disappeared within a few days. We conclude that cardiac dysfunction was found in all five patients and this was reversible in the three surviving the acute episode. Cardiac dysfunction with pulmonary edema following scorpion envenomation (SE) has been documented only in a few isolated case reports. We conducted a systematic hemodynamic study in five consecutive patients (mean age, 21.6±8 years) presenting with pulmonary edema occurring a few hours (9.6±5.2 hours) after SE. All patients had increased pulmonary capillary wedge pressure (mean, 25±1.8 mm Hg) while the systemic vascular resistance was elevated only in one. The stroke volume index was markedly depressed (21.7±3.6 ml/sq m) whereas cardiac index was normal or slightly decreased (2.5±0.4 L/min/sq m). Cerebral infarct and sudden cardiac arrest were the cause of death in two patients. In the three survivors, all the hemodynamic disturbances and respiratory abnormalities disappeared within a few days. We conclude that cardiac dysfunction was found in all five patients and this was reversible in the three surviving the acute episode.