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Echocardiologic evaluation and follow-up of cardiovascular complications in children with scorpion sting in coastal South India.

Kumar CM, Prasad SV - Indian J Crit Care Med (2015)

Bottom Line: Echocardiography revealed decreased ejection fraction (EF), transient mitral regurgitation and wall motion abnormalities were observed.Average EF improved from 16% on day 1 to 47.94% and 59% on day 5 and 14 respectively, which was highly statistically significant.By the end of 1 month, all the survivors had normal EF and no residual cardiac dysfunction was observed at 6 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.

ABSTRACT

Introduction and objective: Scorpion stings are a common emergency in India and many other tropical countries. In India, the red scorpions are more prevalent, and their venom is more likely to cause myocardial dysfunctions. There are very few studies conducted on this problem. The following study was done in Andhra Pradesh and aimed to identify cardiovascular complications of scorpion stings in children with a follow-up of 6 months.

Study design: Prospective observational study.

Setting: Children admitted with scorpion sting in a tertiary care hospital between December 2009 and November 2010 and followed-up till May 2011.

Results: Scorpion stings account for 1 in every 36 admissions. Maximum cases were in 0-3 years age group. Electrocardiogram changes were seen in 76% cases and myocarditis in 42% cases. Echocardiography revealed decreased ejection fraction (EF), transient mitral regurgitation and wall motion abnormalities were observed. Average EF improved from 16% on day 1 to 47.94% and 59% on day 5 and 14 respectively, which was highly statistically significant. By the end of 1 month, all the survivors had normal EF and no residual cardiac dysfunction was observed at 6 months.

Conclusion: Scorpion stings, a common and fatal medical emergency in India, produce echocardiographic changes without any long term residual damage on myocardial activity.

No MeSH data available.


Related in: MedlinePlus

Serial mean left ventricular ejection fraction plotting on echocardiographic follow-up
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Figure 2: Serial mean left ventricular ejection fraction plotting on echocardiographic follow-up

Mentions: All showed improvement on the repeat echo on day 5 with improvement in the left ventricular wall motion. Echocardiographic evaluation of EF on day 1, 5, 14 and 30 showed an unmistakable trend of recovery [Figure 2]. Initial mean EF was 16.42 with SD 1.8. Lowest EF observed was 13%. In seven cases, it crossed 50% on 5th day while 3 of them were still on dobutamine 5 mcg/kg/min. No patient needed dobutamine support beyond 6 days. On the analysis by SPSS, there is a positive correlation between mean EF on day 1 and day 5. The correlation coefficient was found to be 0.679. In the paired sample t-test t is 19.426, and P value is 0.001 which is highly significant. In 10 patients, ECG normalized on 2 week follow-up and in three it normalized at 1 month follow-up. At the end of 1 month mean EF was 60 ± 1.5%. No residual cardiac damage was detected at follow-up over 6 months.


Echocardiologic evaluation and follow-up of cardiovascular complications in children with scorpion sting in coastal South India.

Kumar CM, Prasad SV - Indian J Crit Care Med (2015)

Serial mean left ventricular ejection fraction plotting on echocardiographic follow-up
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296411&req=5

Figure 2: Serial mean left ventricular ejection fraction plotting on echocardiographic follow-up
Mentions: All showed improvement on the repeat echo on day 5 with improvement in the left ventricular wall motion. Echocardiographic evaluation of EF on day 1, 5, 14 and 30 showed an unmistakable trend of recovery [Figure 2]. Initial mean EF was 16.42 with SD 1.8. Lowest EF observed was 13%. In seven cases, it crossed 50% on 5th day while 3 of them were still on dobutamine 5 mcg/kg/min. No patient needed dobutamine support beyond 6 days. On the analysis by SPSS, there is a positive correlation between mean EF on day 1 and day 5. The correlation coefficient was found to be 0.679. In the paired sample t-test t is 19.426, and P value is 0.001 which is highly significant. In 10 patients, ECG normalized on 2 week follow-up and in three it normalized at 1 month follow-up. At the end of 1 month mean EF was 60 ± 1.5%. No residual cardiac damage was detected at follow-up over 6 months.

Bottom Line: Echocardiography revealed decreased ejection fraction (EF), transient mitral regurgitation and wall motion abnormalities were observed.Average EF improved from 16% on day 1 to 47.94% and 59% on day 5 and 14 respectively, which was highly statistically significant.By the end of 1 month, all the survivors had normal EF and no residual cardiac dysfunction was observed at 6 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.

ABSTRACT

Introduction and objective: Scorpion stings are a common emergency in India and many other tropical countries. In India, the red scorpions are more prevalent, and their venom is more likely to cause myocardial dysfunctions. There are very few studies conducted on this problem. The following study was done in Andhra Pradesh and aimed to identify cardiovascular complications of scorpion stings in children with a follow-up of 6 months.

Study design: Prospective observational study.

Setting: Children admitted with scorpion sting in a tertiary care hospital between December 2009 and November 2010 and followed-up till May 2011.

Results: Scorpion stings account for 1 in every 36 admissions. Maximum cases were in 0-3 years age group. Electrocardiogram changes were seen in 76% cases and myocarditis in 42% cases. Echocardiography revealed decreased ejection fraction (EF), transient mitral regurgitation and wall motion abnormalities were observed. Average EF improved from 16% on day 1 to 47.94% and 59% on day 5 and 14 respectively, which was highly statistically significant. By the end of 1 month, all the survivors had normal EF and no residual cardiac dysfunction was observed at 6 months.

Conclusion: Scorpion stings, a common and fatal medical emergency in India, produce echocardiographic changes without any long term residual damage on myocardial activity.

No MeSH data available.


Related in: MedlinePlus