Title: Case Report: Snake bite (Russell’s viper) induced Acute Myocardial Infarction
Authors: Dr Ganesh.K, Prof. Dr S.Balasubramaniyan.M.D., Dr N. Paari M.D.
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.155
Abstract
Introduction
Snake bites are well known emergencies and a cause of hospital admission in many countries. India is one of the world’s most affected country due to its high population density, widespread agricultural activities, presence of numerous venomous snakes and lake of necessary community awareness to address the problem. In India alone it has been estimated that as many as 2.8 million people are bitten by snakes and 46,900 people die from snake bite every year.10
Out of 236 species of snakes in India, 13 species are poisonous and of these four, namely common cobra (Naja naja), Russell’s viper (Dabiola russelii), saw scaled viper (Echis cartinatus) and common krait (Bungarus caeruleus) are highly venomous and believed to be responsible for most of the poisonous bites in India.11
Viper toxins are haemotoxic. Cobra and krait are neurotoxic. Russell’s viper can also manifest with neurotoxic symptoms. Cardiac manifestations are rare in viper bite. Acute myocardial infarction caused by viper bite has been reported rarely. Here we report a case of ST elevation myocardial infarction following Russell’s viper snake bite. This case highlights the cardiovascular complications following viper bite.
References
- Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Haroon Kamran, Joshua Schechter, Stanley Soroka, Abhimanyu Amarnani, Justina Ray, Mena Yacoub, Michael Post, Sama Al-Bayati, and Samy I McFarlane, Myocardial Infarction after Snakebite Envenomation: A Scoping Study Scifed J Cardiol. 2018 ; 2(3):
- Subburaja T, Gandhi TV, Selvyn JR, Subramaniyan K, Sundaravadivelu V. Russell Viper’s Cardiac Bite: A Case Report. Int J Sci Stud 2015; 3(2):237-239.
- Hoffman A, Levi O, Orgad U, Nyska A. Myocarditis following envenoming with viperaepalaestinae in two horses. Toxicon 1993; 31:1623-8.
- Dissanayake P, Sellahewa KH. Acute myocardial infarction in a patient with Russell’s viper bite. Ceylon Med J 1996; 41:67-8.
- Silva et al.: Acute Myocardial Infarction following a possible direct intravenous bite of Russell’s viper (Daboiarusselli). BMC Research Notes 2012 5:500.
- Chakrabarti S, Biswas P, Patil S, Pan K. Acute Myocardial Infarction Following Viper Bite: A Rare Scenario. Heart India 2015; 3:18-20.
- Maheshwari M, Mittal SR. Acute myocardial infarction complicating snake bite. J Assoc Physicians India 2004; 52:63-4.
- Rafael Alessandro Ferreira Gomes, Fabiano Lima Cantarelli, Franklin Almeida Vieira, Aluisio Roberto Andrade Macedo Jr., Milena Motta de Almeida Gouveia, Audes Diogenes de Magalhães Feitosa Myocardial Infarction after Snake Bite International Journal of Cardiovascular Sciences. 2018; 31(1)79 8.
- Niraj et al.: Acute myocardial infarction following a Russell’s viper bite: a case report. International Archives of Medicine 2013 6:7.
- WHO/snakebite envenoming /https://www.who.int/snakebites/epidemiology/en/
- Snake bite– The Association of Physicians of India/ apiindia.org > chapter 94.
- Nicholas G Kounis, Andreas Mazarakis, Grigorios Tsigkas, Sotiris Giannopoulos& John Goudevenos; Kounis syndrome: a new twist on an old disease; Future Cardiol.(2011) 7(6), 805–824.