Cardiac Profile in Patients with Snake Envenomation and Its Complications: A Retrospective Study from a Tertiary Care Center in South India

Abstract Background: Snakebites continue to be a major public health concern throughout the world, and more in tropical countries. Cardiac implications are poorly understood due to the low frequency of cardiotoxicity combined with a lack of robust information. Aims: We aim to study the cardiac profile, complications in snake bite patients requiring admission in a medical unit. Materials and Methods: This retrospective study was conducted carried out from 01/05/2016 to 01/05/2021. The data was extracted from the inpatient medical records and it was analyzed. All adult patients requiring admission in a Medicine unit with a diagnosis of snake envenomation were included. Descriptive statistics were obtained for all variables in the study and appropriate statistical tests were employed to ascertain the significance. Result: The cohort consists of 80 patients with 45(56.3%) males and aged 40.06 ± 15.24 years (mean, SD). The majority of the Snake species identification was not available 38(47.5%). Viper bite was the commonest bite 32 (40%). The commonest clinical presentation was hemotoxic 33 (31.3%) followed by neurotoxic 16(20%). Electrocardiogram abnormalities were seen in 23 (28.7%) patients and commonest abnormality noted was sinus tachycardia 34(42.5%) of cases. 69 (86%) patients had cellulitis and 16(20%) had acute kidney injury (AKI). Twenty-four (30%) required intensive care monitoring, 22 (27.5%) required mechanical ventilation and 7 (8.8%) patients required hemodialysis. The mean ± SD duration of hospital stay was of 5.56 ± 3.76 days. The median direct cost was Rs 19714.5 and cost on medicine was Rs 10798. The mortality in this cohort was 4(5%). Conclusion: Snake bite causes significant morbidity. Viper bite was the commonest bite in our study. The mortality in this cohort was 4(5%). Cardiac toxicity is a clearly defined toxicity following snake bite envenomation however it has no effect on mortality.