A Study of Cardiovascular Manifestations following Venomous Snake Bites in K.R. Hospital Mysuru

Background and Objectives: Snake bite is a neglected tropical disease. Snake venom is a complex mixture of various enzymes, polypeptides and toxins. Paired fang marks, clinical syndromes, size, shape, pattern of markings, behavior helps to identify poisonous snakes. Snakebite causes local effects at bite site, lymphadenopathy, hematotoxicity, clotting disorders, neurotoxicity, nephrotoxicity, DIC. Cardiac manifestations following snakebite is less stressed complication. Hence the study has been conducted to observe clinical, electrocardiographic and cardiac biochemical changes and to study incidence and pattern of cardiotoxicity. Methodology: 120 cases admitted to K.R. Hospital, Mysuru meeting the inclusion criteria were considered in 1 year time period between July 2022 to June 2023. It’s a single centered, time bound and prospective study. Data was entered into Microsoft excel data sheet and was analyzed using SPSS 22 version software. Categorical data was represented in the form of Frequencies and proportions. Chi- square test was used as test of significance for qualitative data. Continuous data was represented as mean and SD. Independent t test was used as test of significance. ANOVA (Analysis of Variance) was the test of significance to identify the mean difference between more than two groups for quantitative and qualitative data respectively. Paired t test is the test of significance for paired data such as before and after surgery for quantitative and qualitative data respectively. Pearson correlation or Spearman’s correlation was done to find the correlation between two quantitative variables and qualitative variables respectively. Results: The study population was mainly in age group of less than 40 years (78.3%) and 75% people affected are males. People involved in agricultural work (86.7%) are more commonly affected and most common site of bite being right lower limb(76.7%). 78.3% people reached hospital within 12hours.Local signs were present in 90%. Vomiting (27.5%), palpitations (11.7%) were present.1.7% people experienced hypotension. ECG changes were seen in 42.5% .Elevated troponin I (5.8%) and CKMB in (5%). ECHO was abnormal in (1.6%).ASV was administered to 100%. 1.6% required vasopressor support.0.8% mortality is observed. Conclusion: Cardiovascular system involvement following snakebite was not rare, it is mandatory to record ECG and estimation of cardiac enzymes as soon as possible in detecting cardio toxic effects following snakebite.