Florentin Jonathan, Farid Karim, Kallel Hatem, Neviere Remi, Resiere Dabor
Department of Critical Care Medicine, Toxicology and Emergency, CHU Martinique (University Hospital of Martinique), Fort-de-France, France.
Cardiovascular Research Team UR5_3 PC2E Pathologie Cardiaque, Toxicité Environnementale et Envenimations, Université des Antilles, Fort-de-France, France.
Front Cardiovasc Med. 2024 Nov 28;11:1421911. doi: 10.3389/fcvm.2024.1421911. eCollection 2024.
(Bl), a snake endemic to Martinique, is responsible for numerous envenomations annually, leading to severe complications such as thrombosis, necrosis, and hemorrhage. This case series investigates the link between envenomation and acute myocarditis, utilizing cardiac magnetic resonance imaging (MRI) to enhance management strategies. In both cases, cardiac MRI confirmed myocarditis with edema, and subsequent cerebral MRI revealed bilateral infarcts. Elevated troponin levels further supported the myocarditis diagnosis. Multiple doses of Bothrofav® antivenom facilitated recovery without clinical after effects.These cases represent the first documented instances of myocarditis due to Bl envenomation confirmed via cardiac MRI. Prompt administration of antivenom and the use of advanced imaging techniques were crucial in achieving favorable outcomes.
(矛头蝮蛇)是马提尼克岛特有的一种蛇,每年导致大量蛇咬伤中毒事件,引发诸如血栓形成、坏死和出血等严重并发症。本病例系列研究蛇咬伤中毒与急性心肌炎之间的联系,利用心脏磁共振成像(MRI)来改进治疗策略。在这两个病例中,心脏MRI证实存在伴有水肿的心肌炎,随后的脑部MRI显示双侧梗死。肌钙蛋白水平升高进一步支持了心肌炎的诊断。多剂Bothrofav®抗蛇毒血清促进了康复且无临床后遗症。这些病例是通过心脏MRI确诊的因矛头蝮蛇咬伤中毒导致心肌炎的首批记录实例。及时给予抗蛇毒血清和使用先进成像技术对取得良好结果至关重要。