title: Electrocardiologic and echocardiographic features of patients exposed to scorpion bite.
abstract: The purpose of this study is to examine clinical progress and hemodynamic and electrocardiologic features (QT depression and heart rate variability [HRV]) of patients exposed to a scorpion bite. Seventeen patients bitten by scorpions, and, as a control group, 15 healthy subjects were included in the study. Standard electrocardiograph (ECG) records, 24-hour Holter-ECG, and Doppler echocardiographic examinations were performed. Holter ECG indicated sinus tachycardia, sinus bradycardia, paroxysmal supraventricular tachycardia, atrial fibrillation, first-degree and second-degree atrioventricular block not requiring treatment, early atrial beats, and early ventricular beats in the patients at frequencies of 82%, 12%, 35%, 12%, 8%, 70%, and 47%, respectively. HRV parameters that reflected parasympathetic activity (SD 35+/-13-43+/-16, RMS-SD: 20+/-9-30+/-12, high frequency: 7.8+/-2-4.3+/-3, p<0.05) were significantly lower (p<0.05). Low frequency, which especially showed sympathetic activity (LF: 11+/-13-11+/-23, p>0.05), was similar in both groups. In addition, the LF/HF ratio, which reflected sympathovagal balance, was significantly increased in the patient group (1.5+/-1-3.0+/-2, p=0.005). Corrected QT and QT dispersion values were not significantly different with respect to the control (p>0.05). In the patient group compared to the control, a significant decrease was determined in the proportion of mitral E velocity to mitral A velocity (mEv/mAv), diastolic filling period (DFP), and left ventricular ejection fraction (LVEF), while a significant increase was noticed in pulmonary artery pressure (PAP) (mEv/mAv: 0.9+/-0.4-1.7+/-0.6, DFP: 362+/-8.5-425+/-89, LVEF: 53.1+/-6.7-68.6+/-5.8, PAP: 38.1+/-13-27.2+/-6, p<0.05). Scorpion bite leads to serious cardiovascular disorders, associated with decreased HRV, decreased systolic and diastolic functions, increased arrhythmic events, and hemodynamic disturbance with sympathetic and parasympathetic balance disturbance.
authors.affiliation: Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey. alansait@hotmail.com
authors.forename: Sait
authors.initials: S
authors.lastname: Alan
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Ulgen
authors.forename: Murat
authors.initials: M
authors.lastname: Soker
authors.forename: Faruk
authors.initials: F
authors.lastname: Geyik
authors.forename: Aziz
authors.initials: A
authors.lastname: Karabulut
authors.forename: Nizamettin
authors.initials: N
authors.lastname: Toprak
mesh_terms: D000293:Adolescent; D000818:Animals; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D065008:Scorpion Stings / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012605:Scorpions