Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2023; 15(1): 33-44
Published online Jan 26, 2023. doi: 10.4330/wjc.v15.i1.33
Takotsubo cardiomyopathy following envenomation: An updated review
Ajay K Mishra, Anu A George, Kevin John John, Pramukh Arun Kumar, Mahati Dasari, Mohammed Afraz Pasha, Michelle Hadley
Ajay K Mishra, Michelle Hadley, Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
Anu A George, Pramukh Arun Kumar, Mahati Dasari, Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Kevin John John, Department of Medicine, Tufts Medical Center, Boston, MA 02111, United States
Mohammed Afraz Pasha, Department of Medicine, North Alabama Medical Center, Florence, AL 35630, United States
Author contributions: Mishra AK, George AA, Hadley M planned and formulated the study; GeorgeAA, John KJ, ArunKumar P, Dasari M, Pasha MA collected and analyzed the data; Mishra AK, George AA completed the manuscript; Mishra AK, Hadley M reviewed the manuscript and Hadley M approved the manuscript; All authors reviewed and agreed with the final content of the article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: All the authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ajay K Mishra, MBBS, MD, Academic Fellow, Division of Cardiology, Saint Vincent Hospital, No. 123 Summer Street, Worcester, MA 01608, United States. ajay.mishra@stvincenthospital.com
Received: September 11, 2022
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
Core Tip

Core Tip: Multiple envenomations following insect stings and reptile bites can cause Takotsubo cardiomyopathy. 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 clinical presentation of acute coronary syndrome, ST elevation, and elevated troponin. Echocardiography commonly shows an apical pattern of cardiomyopathy. This cardiomyopathy improves with medical management.