Scorpion bites are common in India. Usually, these bites are harmless but sometimes have serious clinical sequelae, including death. We report herein a case of scorpion bite with electrocardiographic abnormalities simulating early myocardial infarction. Pulmonary edema and congestive heart failure accompanied these electrocardiographic changes as well as serum cardiac markers. The etiology of cardiovascular manifestations in severe scorpion sting is related to venom effect on sympathetic nervous system and the adrenal secretion of catecholamines as well as to the toxic effect of the venom on the myocardium itself. It is a rare case of scorpion sting presented as myocardial infarction and heart failure, successfully treated with Intensive Care Unit care, noninvasive ventilation, vasopressors, and antiischemic treatment.
Bawaskar HS, Bawaskar PH. Indian red scorpion envenoming. Indian J Pediatr 1998;65:383-91.
Wallace JF. Disorders caused by venoms, bites and stings. In: Isselbacher KJ, Adams RD, Braunwald E, Petersdorf RG, Wilson JD, editors. Harrison′s Principles of Internal Medicine. 9 th ed. Johannesburg, London, Tokyo, etc.: McGraw-Hill International Book Co.; 1980. p. 924-5.
Mundle PM. Pulmonary edema following scorpion stings. Br Med J 1961;1:1042.
Yang HP, Chen FC, Chen CC, Shen TY, Wu SP, Tseng YZ. Manifestations mimicking acute myocardial infarction after honeybee sting. Acta Cardiol Sin 2009;25:31-5.
Bawaskar HS, Bawaskar PH. Management of scorpion sting. Heart 1999;82:253-4.
Bahloul M, Kallel H, Rekik N, Ben Hamida C, Chelly H, Bouaziz M. Cardiovascular dysfunction following severe scorpion envenomation. Mechanisms and physiopathology. Presse Med 2005;34:115-20.
Valdivia HH, Kirby MS, Lederer WJ, Coronado R. Scorpion toxins targeted against the sarcoplasmic reticulum Ca (2+)-release channel of skeletal and cardiac muscle. Proc Natl Acad Sci U S A 1992;89:12185-9.
Levine HD. Acute myocardial infarction following wasp sting. Report of two cases and critical survey of the literature. Am Heart J 1976;91:365-74.
Wagdi P, Mehan VK, Bürgi H, Salzmann C. Acute myocardial infarction after wasp stings in a patient with normal coronary arteries. Am Heart J 1994;128:820-3.