Scorpion Sting Masquerading As Myocardial Infarction

Scorpion stings are common in rural India and envenomation by scorpions can result in a wide range of clinical effects, including, cardiotoxicity, neurotoxicity and respiratory dysfunction. In general, scorpions are not aggressive. They do not hunt for prey; they wait for it. Scorpions are nocturnal creatures; they hunt during the night and hide in crevices. Scorpion venom is a water-soluble, antigenic, heterogenous mixture, as demonstrated on electrophoresis studies. Out of 1500 scorpion species known to exist, about 30 are of medical importance. The life-threatening complication of myocarditis and pulmonary edema is known in red scorpion. Most deaths occur during the first 24 hours after the sting and are secondary to respiratory or cardiovascular failure. In spite of advances in patho-physiology and therapy the mortality remains high in rural areas due to lack of access to medical facilities. In absence of clear history, the cardiac toxicity of scorpion sting may be misdiagnosed.