Echocardiography Guided Therapy for Myocarditis after Scorpion Sting Envenomation
Objective: This study was to evaluate echocardiographic findings and its usefulness in clinical management of patients with scorpion sting envenomation. Material and Methods: A total of 84 consecutive patients were prospectively studied. The data included demographics, at the time of presentati...
Main Authors: | , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2013-12-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/3693/49-%206791_E(C)_F(DK)_PF1(VP)_PFA(H)_OLF_(U)_PF2(PP).pdf |
Summary: | Objective: This study was to evaluate echocardiographic
findings and its usefulness in clinical management of patients
with scorpion sting envenomation.
Material and Methods: A total of 84 consecutive patients
were prospectively studied. The data included demographics,
at the time of presentation to the hospital, the clinical features,
echocardiographic findings, admission to intensive care unit, use
of inotropic medication, time to discharge, and mortality.
Results: Out of 84 patients studied 60 patients (71.4%) had
echocardiographic evidence of myocarditis (LVEF <50%). Majority of patients had LVEF <40% (50 patients, 83.3%). Severe
LV dysfunction (LVEF <30%) was noted in 20 patients (33.3%).
No patient had significant valvular regurgitation. RV dysfunction
was noted in half of the patients who had LV dysfunction. RV
dysfunction was not seen in isolation. Twenty four patients
without evidence of myocarditis on echocardiography were
observed in general wards and were discharged in 24 to 48
hours of admission. Ten patients with mild LV dysfunction (LVEF
50-40%) and 20 patients with moderate LV dysfunction were
observed in high dependency units with regular monitoring for
24 to 48 hours. Only 3 patients were put on inotropics support
and others could be discharged in 72 to 96 hours. All the patients
with severe LV dysfunction and moderate LV dysfunction with
significant RV dysfunction were admitted in intensive care unit
irrespective of symptoms (Total 30 patients). These patients were
put on inotropics support. Among severe LV dysfunction group,
4 patients required ventilator support and 2 (2.3%) patients died
with refractory shock and multi-organ failure. Tachycardia, muffled
and or gallop heart sounds and hypertension didn’t predict
presence of LV dysfunction. Persistent hypotension requiring
inotropics support was a marker of severe LV dysfunction.
Conclusion: Echocardiography is a useful tool in emergency to
assess LV function in patients with scorpion sting envenomation.
It can guide therapy by identifying patients with severe LV
dysfunction. |
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ISSN: | 2249-782X 0973-709X |