DOI: 10.46871/eams.1946903 ISSN: 2757-847X

Scorpion Sting-Associated Cardiotoxicity in an Elderly Patient: A Case Report and Brief Clinical Discussion

Muhammed Enes Taysı, Mustafa Enes Demirel
Show PDF Cite
Scorpion stings are generally associated with local symptoms, but they may also cause systemic toxicity, including clinically significant cardiac involvement. We report an 84-year-old woman with a history of hypertension who presented to the emergency department (ED) after a scorpion sting to the left great toe. Her initial complaint was localized pain, and vital signs were stable on admission. Subsequent evaluation demonstrated elevated high-sensitivity cardiac troponin T (hs-cTnT) levels. The initial electrocardiogram (ECG) showed T-wave inversion in V2 and the lateral precordial leads (V5-V6), without dynamic changes on repeat recordings. Transthoracic echocardiography (TTE) showed a left ventricular ejection fraction of 35%, with mild aortic, tricuspid, and mitral regurgitation. Myocardial injury or cardiotoxicity due to scorpion venom was suspected, and one vial (1 mL) of scorpion antivenom was administered intravenously as a slow infusion over 30 minutes in the ED. The patient was admitted to the coronary intensive care unit (CICU), and coronary angiography was recommended; however, she declined the procedure and further in-hospital evaluation and treatment. Acute coronary syndrome could not be fully excluded. She left the hospital voluntarily after informed refusal was documented. At subsequent clinical follow-up, the patient reported no complaints, and repeat cardiac enzyme testing was not suggestive of ongoing myocardial injury. This case highlights that scorpion sting-associated cardiotoxicity can occur in older adults despite minimal systemic manifestations, underscoring the importance of serial ECG, cardiac biomarker monitoring, cardiology consultation, and close observation.

More from our Archive