Lack of myocardial damage following Sri Lankan Russell's viper and hump-nosed viper bites

Abstract

INTRODUCTION: Cardiac effects following the bite of Burmese Russell's vipers and European vipers are well known. The question whether envenomation caused by Sri Lankan viper bites results in myocardial damage remains largely unanswered. The aim of this prospective study was to investigate whether myocardial damage occurs after Sri Lankan viper bites, using a highly specific and sensitive marker, troponin T. METHODS: 45 patients admitted after a definite viper bite [Russell's viper (RV), n = 13, hump-nosed viper (HNV), n = 32] were studied with regard to cardiac symptoms, ECG changes, and troponin T levels. There were no admissions with bites of other types of Sri Lankan vipers during the study period. RESULTS: Cardiac symptoms were present in a number of patients following the bite. Two patients had transient ECG changes. However, troponin T levels were not elevated in any of them. COMMENT: Myocardial damage does not seem to be an important feature of Sri Lankan Russell's and hump-nosed viper bites. This may be because of venom heterogeneity in vipers, that is based on their geographical distribution.