Evidence of myocardial ischaemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study.
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.
Bahloul
Mabrouk
M
Service de Réanimation médicale, CHU Habib Bourguiba, Route el Ain Km 1, 3029 Sfax, Tunisia.
Ben Hamida
Chokri
C
Chtourou
Khalil
K
Ksibi
Hichem
H
Dammak
Hassen
H
Kallel
Hatem
H
Chaari
Adel
A
Chelly
Hedi
H
Guermazi
Fadhel
F
Rekik
Noureddine
N
Bouaziz
Mounir
M
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
D011868:Radioisotopes; D013793:Thallium