Snake Envenomation Simulating ST Elevation Myocardial Infarction

Abstract

Envenomation syndromes following snakebites can include tissue reaction, coagulopathy, nephrotoxicity, and neurotoxicity. Cardiotoxicity is rare but usually presents with dysrhythmias. Myocardial infarction after envenomation has rarely been reported. We discuss a case of snake bite simulating ST-elevation myocardial infarction (STEMI). Our patient is a 49-year-old male who sustained a snake bite in his left hand. Patient had hemodynamic collapse requiring increasing pressor support; EKG and troponin results confirmed STEMI. Cardiac catheterization did not demonstrate any thrombosis, rather severe cardiomyopathy with left ventricular ejection fraction 20-25%. Even though our patient did not require any coronary intervention, an angiogram was warranted given the clinical presentation. Our case demonstrates severe cardiotoxicity following snake bite. Further research is warranted to study the mechanism behind such phenomena.