“Cardiopatía por picadura de alacrán”

Abstract

The arthropod bite of the order Scorpionida is common in Latin American countries; In the Ecuadorian Amazon, the reports of patients without major complications are common; however, infrequent circumstances such as toxic myocarditis, pulmonary edema, shock and even death exist. The present case aims to analyze the set of facts that led to a 29 - year - old male patient with no history of cardiovascular disease suffering from scorpion sting (Tityus Asthenes) on the left hand ring finger, referring to severe burning pain, Paraesthesia of the tongue, paresis of limbs, vomiting, thermal rise, optical hallucinations, decreased level of consciousness, and headache olocraneana, that after remaining 12 hours in the hospital of Puerto Francisco de Orellana, shows signs of pulmonary congestion evolving rapidly to Left ventricular systolic dysfunction, requiring hospitalization in the intensive care area, so it is transferred to General Puyo Hospital where treatment with inotropic and corticoid is started. Patient who presented diffuse crackling in the lungs on his arrival in the emergency area. In addition, the electrocardiogram showed sinus tachycardia with no T wave or ST segment abnormalities. The echocardiogram revealed acute myocarditis, dilated inferior vena cava with elevated right atrial pressure and the dilated left ventricle, evidently remodeled. According to the described, the diagnosis of acute myocarditis with pulmonary edema is made. Dopamine, dobutamine, hydrocortisone and diuretics were given with which the patient rapidly improved. After his hospital stay in the intensive care area and in the area of internal medicine the patient recovers in its entirety. At the moment it leads a normal life totally integrated to the labor, social and sport life. Periodic monitoring, monitoring and evaluation by the internal medicine and cardiology service were found to be substantial clinical improvement in each of them, as well as normal laboratory results.