Published online Jan 26, 2023. doi: 10.4330/wjc.v15.i1.33
Peer-review started: September 11, 2022
First decision: November 2, 2022
Revised: November 15, 2022
Accepted: November 15, 2022
Article in press: November 15, 2022
Published online: January 26, 2023
Processing time: 122 Days and 4.7 Hours
Multiple different physical, emotional and iatrogenic stressors have been known to precipitate stress induced cardiomyopathy also called takotsubo cardiomyopathy (TTC).
Rarely TTC has been reported in patients following an episode of acute envenomation secondary to insect stings and reptile bites.
This review aimed to narrate the current literature on the patterns, mechanisms, and outcomes of envenomation induced TTC.
This review included all studies on “TTC” and “envenomation “published in PubMed, Google Scholar, and Reference Citation Analysis databases before June 2022. Articles had to have a distinct diagnosis of TTC with Revised Mayo Clinical Criteria and documented envenomation.
Envenomation related TTC was reported from all over the world. The reports of envenomation induced TTC were reported mostly following a bee sting, scorpion sting, and snake envenomation. Fear and anxiety related to the sting, direct catecholamine toxicity, and administration of exogenous beta-adrenergic agents were postulated to precipitate TTC in these patients. Most patients presented with a clinical picture of acute coronary syndrome (ACS), ST elevation, and elevated troponin. Echocardiographic evidence of Apical TTC was noted in most of the patients. Almost all of these patients had clinical improvement following optimal management.
Envenomation following multiple insect stings and reptile bites can precipitate TTC. Most reported envenomation related TTC has been due to bee and scorpion stings. Common mechanisms causing TTC following envenomation are fear, anxiety, and stress. Most of these patients present with clinical presentation of ACS. The most common type of TTC in these patients is Apical, which improved following medical management.
Multiple envenomations following insect stings and reptile bites can cause TTC. Worldwide bee stings, wasp stings, scorpion stings, snake bites, spider bites, and jellyfish stings are the commonly reported precipitators of this cardiomyopathy. Multiple mechanisms have been postulated to cause this of which fear, anxiety, and stress of envenomation are the predominant ones. Patients usually present with a clinical presentation of ACS. Echocardiography commonly shows an apical pattern of cardiomyopathy. This cardiomyopathy improves with medical management.