{"title":"Does black widow spider bite the heart?","authors":"Behzad Alizadeh , Pegah Bahrami Taghanaki , Shirin Sadat Ghiasi , Elham Nikrouh , Ghazaleh Pourali , Anahita Alizadeh Ghamsari , Feisal Rahimpour","doi":"10.1016/j.ppedcard.2024.101728","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Black widow spider (BWS) bites account for 0.5 % of global poisonings and 21 % of poisonings in North-East Iran. In addition to local reactions, systemic cardiovascular manifestations are likely to occur.</p></div><div><h3>Objective</h3><p>This study aims to present cases of patients who experienced cardiac symptoms after being envenomed by BWS.</p></div><div><h3>Methods</h3><p>A descriptive retrospective cross-sectional evaluation was conducted on all patients who were bitten by a BWS in 2020 and presented with cardiac manifestations. They were referred to our tertiary pediatric cardiology center in Mashhad, Iran for evaluation. All accessible variables including history, physical examination, laboratory tests prioritizing cardiology, as well as electrocardiography and echocardiography findings, were evaluated.</p></div><div><h3>Result</h3><p>Six patients, ranging in age from 5.5 to 13 years old, were bitten by BWS. None of the patients had a past or drug history and were admitted due to pain complaints at various bite sites that radiated in different directions. Four patients showed signs of tachycardia, and two showed hypertension, but no signs of infection were observed. Half of the patients experienced systemic complications. Upon arrival at the hospital, four patients showed elevated CKMB levels, which decreased during their hospitalization. Troponin I and N-Terminal Pro B-type Natriuretic Peptide levels were high in all patients. One patient with unstable hemodynamics showed pro-BNP over 35,000. T wave inversion was observed in six patients, ST segment depression in three patients, and ST-segment elevation in one patient, with overlap between them.</p></div><div><h3>Conclusion</h3><p>Taking notice of cardiovascular presentations after a BWS bite is considerable.</p></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":null,"pages":null},"PeriodicalIF":0.6000,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PROGRESS IN PEDIATRIC CARDIOLOGY","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1058981324000262","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Black widow spider (BWS) bites account for 0.5 % of global poisonings and 21 % of poisonings in North-East Iran. In addition to local reactions, systemic cardiovascular manifestations are likely to occur.
Objective
This study aims to present cases of patients who experienced cardiac symptoms after being envenomed by BWS.
Methods
A descriptive retrospective cross-sectional evaluation was conducted on all patients who were bitten by a BWS in 2020 and presented with cardiac manifestations. They were referred to our tertiary pediatric cardiology center in Mashhad, Iran for evaluation. All accessible variables including history, physical examination, laboratory tests prioritizing cardiology, as well as electrocardiography and echocardiography findings, were evaluated.
Result
Six patients, ranging in age from 5.5 to 13 years old, were bitten by BWS. None of the patients had a past or drug history and were admitted due to pain complaints at various bite sites that radiated in different directions. Four patients showed signs of tachycardia, and two showed hypertension, but no signs of infection were observed. Half of the patients experienced systemic complications. Upon arrival at the hospital, four patients showed elevated CKMB levels, which decreased during their hospitalization. Troponin I and N-Terminal Pro B-type Natriuretic Peptide levels were high in all patients. One patient with unstable hemodynamics showed pro-BNP over 35,000. T wave inversion was observed in six patients, ST segment depression in three patients, and ST-segment elevation in one patient, with overlap between them.
Conclusion
Taking notice of cardiovascular presentations after a BWS bite is considerable.
背景黑寡妇蜘蛛（BWS）咬伤占全球中毒事件的 0.5%，占伊朗东北部中毒事件的 21%。本研究旨在介绍被黑寡妇蜘蛛咬伤后出现心脏症状的患者病例。方法 对 2020 年被黑寡妇蜘蛛咬伤并出现心脏症状的所有患者进行了描述性回顾性横断面评估。这些患者被转诊至伊朗马什哈德的三级儿科心脏病中心进行评估。对所有可获得的变量进行了评估，包括病史、体格检查、心脏病学优先实验室检查以及心电图和超声心动图检查结果。结果六名患者被 BWS 咬伤，年龄从 5.5 岁到 13 岁不等。这些患者均无既往病史或药物史，入院原因是主诉被咬部位疼痛，并向不同方向放射。四名患者出现心动过速症状，两名患者出现高血压，但未发现感染迹象。半数患者出现全身并发症。到达医院时，四名患者的 CKMB 水平升高，但在住院期间有所下降。所有患者的肌钙蛋白 I 和 N 端 Pro B 型钠尿肽水平都很高。一名血流动力学不稳定的患者的前 BNP 超过 35000。六名患者出现 T 波倒置，三名患者出现 ST 段压低，一名患者出现 ST 段抬高，三者之间有重叠。
期刊介绍：
Progress in Pediatric Cardiology is an international journal of review presenting information and experienced opinion of importance in the understanding and management of cardiovascular diseases in children. Each issue is prepared by one or more Guest Editors and reviews a single subject, allowing for comprehensive presentations of complex, multifaceted or rapidly changing topics of clinical and investigative interest.
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