D. Acevedo
, L. Padrino, V. Ovalles, M. Contreras, J. Ortiz
Centro Cardiovascular "Dr. Mariano Alvarez" de Maturín y Hospital "Dr. Nicolas Giannini" de Quiriquire, Estado Monagas, Venezuela.
Envenomings in the central region of Venezuela, the Federal District, and Miranda State are related to the presence of the scorpion Tityus discrepans. In the municipalities of Punceres and Bolivar, endemic areas of scorpion envenoming in the central-north region of Monagas State, the new species Tityus caripitensis (Quiroga, 1988) has also been linked to envenomings (De Sousa et al., Cad. Saúde Púb. 13: 45-51, 1997). It has been widely demonstrated experimentally that scorpion toxins affect the excitable cells, such as cardiac cells, thus affecting the heart. Electrocardiographic disturbances (ED) have been reported during the acute phase in human envenomation. However, possible late disturbances in the electric function of the heart have not been reported, establishing the objective of this study. This is a prospective and descriptive study involving the rural population of El Limón de Quiriquire in the Punceres municipality, Monagas State. One hundred and two volunteers (64 females and 38 males) aged between 10 and 60 years old (mean age 29.6 years) were chosen at random. The criteria adopted to obtain the clinical history of these volunteers were, as follows: no antecedents or evidence of congenital or acquired cardiovascular diseases (for instance, Chagas disease), no arterial hypertension, and no coronary failure. The paraclinical electrocardiographic examination (ECG) was carried out using a three-channel Fukuda D machine at V: 25 mm/sec. The results indicated that of the 102 patients evaluated, 75 (73.5%) had antecedents of scorpion envenomation of varying severities, with females showing the highest incidence. Of the 75 patients, 24% were farmers, 26.7% housewives, and 45.3% students. The ECG showed alterations in the voltage of the QRS (DI, DII, DIII) limited to specific faces of the heart in 12.8%, limit PR of 0.20 sec (11.5%), short PR of 0.09 sec (6.4%), notches of 20 msec in QRS in the inferior face (16.6%), lateral face (11.5%) and antero septal face (2.5%). It also showed alterations in the T wave (6.4%), non-advanced block of right branch of His bundle (NABRBHB) (5.2%), and NABRBHB + Hemiblockade of anterior subdivision (HAS) (1.2%). The patients without antecedents or evidence of cardiovascular diseases but with antecedents of scorpion envenomation showed ED indicative of the early stages of conduction alterations in the heart impulse. It could be assumed that these alterations have been caused by late-stage immunological reactions in these specialized heart cells.
Publication Dates
-
Publication in this collection
16 Apr 1999 -
Date of issue
1999
