title: Evidence of myocardial ischaemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study.
abstract: OBJECTIVE
  To explore the myocardial perfusion by thallium-201 scintigraphy for patients with evidence of myocardial damage after scorpion envenomation.
  
  
  METHODS
  Prospective study over 1-year period.
  
  
  METHODS
  Medical intensive care unit of a university hospital (Sfax, Tunisia).
  
  
  METHODS
  We have prospectively included six patients admitted for scorpion envenomation over a period of 1 year in the 22-bed intensive care unit (ICU) of our university hospital. The evidence of myocardial damage was confirmed by electrocardiography and echocardiography in all patients. Myocardial perfusion scintigraphy ((201)Tl scintigraphy) coupled with radionuclide ventriculography ((99m)Tc) was performed for all patients, occurring 32 h on average (range 12-72 h) after the sting.
  
  
  RESULTS
  Radionuclide ventriculography was abnormal in all cases; the abnormalities observed were similar to those observed by echocardiography. Moreover (201)Tl scintigraphy showed evidence of myocardial hypoperfusion in all cases. The myocardial hypoperfusion grade and localisation were more marked in the abnormal localisation shown by echocardiography and electrocardiography, compared to the normal wall. Repeated studies, obtained only in two patients within 6 and 15 days, respectively, showed considerable, but not complete, improvement of wall motion and myocardial perfusion. Segments with improved perfusion showed greatly improved regional wall motion.
  
  
  CONCLUSIONS
  This study confirms the evidence of myocardial hypoperfusion after severe scorpion envenomation.
authors.affiliation: Service de Réanimation médicale, CHU Habib Bourguiba, Route el Ain Km 1, 3029 Sfax, Tunisia.
authors.forename: Mabrouk
authors.initials: M
authors.lastname: Bahloul
authors.forename: Chokri
authors.initials: C
authors.lastname: Ben Hamida
authors.forename: Khalil
authors.initials: K
authors.lastname: Chtourou
authors.forename: Hichem
authors.initials: H
authors.lastname: Ksibi
authors.forename: Hassen
authors.initials: H
authors.lastname: Dammak
authors.forename: Hatem
authors.initials: H
authors.lastname: Kallel
authors.forename: Adel
authors.initials: A
authors.lastname: Chaari
authors.forename: Hedi
authors.initials: H
authors.lastname: Chelly
authors.forename: Fadhel
authors.initials: F
authors.lastname: Guermazi
authors.forename: Noureddine
authors.initials: N
authors.lastname: Rekik
authors.forename: Mounir
authors.initials: M
authors.lastname: Bouaziz
mesh_terms: D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology*; D011446:Prospective Studies; D011868:Radioisotopes; D011875:Radionuclide Angiography; D065008:Scorpion Stings / Q000150:complications*; D012605:Scorpions; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D011868:Radioisotopes; D013793:Thallium