Wu HanDong, Zhou KeChun, Ma XiaoTong
Department of Emergency Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui Hospital of Zhejiang University, Lishui, Zhejiang, China.
Front Cardiovasc Med. 2025 Jun 3;12:1598373. doi: 10.3389/fcvm.2025.1598373. eCollection 2025.
, commonly known as the Taiwan habu, is a highly venomous snake species. Its venom is rich in haemotoxins and neurotoxins, capable of inducing severe coagulopathy, tissue necrosis, and multi-organ damage. However, to date, there have been no reported cases of Takotsubo cardiomyopathy (TTS) triggered by envenomation from . TTS is characterised by transient left ventricular dysfunction precipitated by acute stress events and is typified by abnormalities in left ventricular wall motion, often mimicking the clinical presentation of coronary artery disease.
This report presents a rare case of Takotsubo cardiomyopathy (TTS) triggered by envenomation from . Following the snakebite, the patient rapidly developed severe pain and bleeding at the bite site, and subsequently experienced acute chest tightness and chest pain during hospitalisation. To elucidate the aetiology, the patient underwent a series of investigations, including electrocardiography, transthoracic echocardiography, and coronary angiography, which ultimately confirmed the diagnosis of TTS. The patient received comprehensive treatment comprising administration of anti-venom serum to neutralise the venom, fluid resuscitation, and antiplatelet therapy. The clinical condition gradually stabilised, and the patient was eventually discharged in good health.
envenomation may precipitate Takotsubo cardiomyopathy (TTS). Given the considerable overlap in early clinical presentation between TTS and acute myocardial infarction (AMI), early utilisation of echocardiography, coronary angiography, and fractional flow reserve (FFR) assessment is crucial for accurate diagnosis. The cornerstone of treatment lies in the prompt and adequate administration of anti-venom serum, combined with fluid resuscitation and supportive symptomatic care. The judicious use of antiplatelet agents after restoration of coagulation function is generally considered safe and does not significantly increase the risk of bleeding.
，俗称台湾哈布蝰，是一种剧毒蛇类。其毒液富含血液毒素和神经毒素，能够引发严重的凝血病、组织坏死和多器官损伤。然而，迄今为止，尚无由 咬伤引发应激性心肌病（TTS）的病例报道。TTS的特征是由急性应激事件诱发的短暂性左心室功能障碍，其典型表现为左心室壁运动异常，常与冠状动脉疾病的临床表现相似。
本报告呈现了一例罕见的由 咬伤引发应激性心肌病（TTS）的病例。被蛇咬伤后，患者咬伤部位迅速出现剧痛和出血，随后在住院期间经历了急性胸闷和胸痛。为明确病因，患者接受了一系列检查，包括心电图、经胸超声心动图和冠状动脉造影，最终确诊为TTS。患者接受了综合治疗，包括注射抗蛇毒血清以中和毒液、液体复苏和抗血小板治疗。临床状况逐渐稳定，患者最终康复出院。
咬伤可能引发应激性心肌病（TTS）。鉴于TTS与急性心肌梗死（AMI）在早期临床表现上有相当大的重叠，早期使用超声心动图、冠状动脉造影和血流储备分数（FFR）评估对于准确诊断至关重要。治疗的关键在于及时、充分地注射抗蛇毒血清，同时进行液体复苏和支持性对症治疗。在凝血功能恢复后谨慎使用抗血小板药物通常被认为是安全的，且不会显著增加出血风险。
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