%0 Journal Article
%T Study of Cardiac Changes in Egyptian Children with Scorpion Envenomation Before and After Antivenin Therapy
%A Tarek A. Abd El-Gawad
%A Hanan M.M. Ibrahim
%A Sally A.F. El-Sahrigy
%A Hala A. Sherif
%J Journal of Medical Sciences
%D 2006
%I 
%X Scorpionism is an endemic health problem in Upper Egypt. This study shows cardiac complications secondary to scorpion envenomation and establishes the clinical utility of antivenin in reversing this cardiac dysfunction. This study included 40 children (5.9¡À4.2 years) and 25 healthy age and sex matched controls. They presented to Luxor Hospital after scorpion sting. They were classified into mild, moderate and severe groups. ECG and echocardiographic studies performed for cardiac evaluation. Lactate dehydrogenase (LDH), serum creatinine phosphokinase (CPK), serum CPK- MB and serum cardiac troponin I (cTnI) were studied at admission and 24 h after antivenin therapy. ECG revealed a significant increase in frequency of heart block (p<0.01), elevated ST segment (p<0.05) and ventricular ectopies (p<0.01) in the severe group as compared to the moderate group. Echocardiography revealed significant decrease in left ventricular ejection fraction LVEF% (p<0.01) and fractional shortening FS% (p<0.01) in severe and moderate cases as compared to mild group. In comparison to mild group the mean values of LDH, CPK, CPK- MB and cTnI were significantly higher in both moderate and severe groups at admission (p<0.0001) with significant decrease in both groups after antivenin therapy (p<0.001). Non- survivors showed significant reduction in LVEF% and FS% (p<0.01) with significant increase in all the biochemical markers in comparison to survivors (p<0.001). In conclusion, antivenin therapy is effective in the reversibility of the cardiac changes following scorpion envenomation if given in the first two hours after sting. Delay in treatment may lead to irreversible cardiac damage.
%K Cardiac changes
%K scorpion envenomation
%K cardiac enzymes
%K antivenin
%U http://docsdrive.com/pdfs/ansinet/jms/2006/1033-1038.pdf