Scorpion Toxic Myocarditis and Scorpion Cardiomyopathy

Mechanism(s): toxic myocarditis, massive release of catecholamines with vasoconstriction

Some cases may share features with Takotsubo (stress-induced) cardiomyopathy.

Clinical features:

(1) hypotension

(2) reduced left ventricular ejection fraction (LVEF)

(3) pulmonary edema

(4) right ventricular dysfunction

(5) cardiac arrest or sudden death in severe cases

Imaging studies:

(1) There may be myocardial edema seen on T2-weighted MRI.

(2) Ventricular hypokinesis on echocardiography.

Laboratory findings:

(1) elevated serum troponin concentration

The diagnosis requires exclusion of other causes of myocardial damage such as coronary artery and/or valvular disease.

Administration of specific antivenom can prevent or reduce the severity of myocarditis.