Agarwal R, Singh A P, Aggarwal A N
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
Singapore Med J. 2007 Aug;48(8):e227-30.
Cardiotoxicity is an unusual manifestation of severe neurotoxic snake envenoming and is previously unreported with snake bites due to kraits. We describe a 26-year-old male Indian farmer who developed cardiogenic pulmonary oedema after neurotoxic snake envenoming by Bungarus caeruleus (Indian krait). We also review the literature on cardiac manifestations, the possible mechanisms and treatment of patients with cardiotoxicity accompanying neurotoxic snake envenoming. Cardiac involvement can complicate the course of snakebites. Recognition of cardiac involvement can warn the emergency physician and intensivist to be cautious, and anticipate the complications, such as pulmonary oedema, so that they can be rapidly and appropriately managed.
心脏毒性是严重神经毒性蛇咬伤的一种罕见表现，此前从未有关于金环蛇咬伤导致心脏毒性的报道。我们描述了一名26岁的印度男性农民，他被印度金环蛇（Bungarus caeruleus）咬伤导致神经毒性后出现了心源性肺水肿。我们还回顾了有关神经毒性蛇咬伤伴发心脏毒性患者的心脏表现、可能机制及治疗的文献。心脏受累会使蛇咬伤的病程复杂化。认识到心脏受累可提醒急诊医生和重症监护医生保持谨慎，并预见到诸如肺水肿等并发症，以便能够迅速且恰当地进行处理。
