What is the role of imaging studies in the workup of scorpion envenomation?

Updated: Nov 09, 2018
  • Author: David Cheng, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Obtain a chest radiograph in cases of respiratory difficulty. Unilateral pulmonary edema may be seen on chest x-ray films because of the venom effect on pulmonary vascular permeability.

Echocardiography is more sensitive than electrocardiography and creatine kinase assays for assessing myocardial compromise after a scorpion sting. Findings show a diffuse global biventricular hypokinesis with a decreased left and right ventricular ejection fraction of approximately 0.14-0.38. This dysfunction can appear just a few hours after the sting and usually normalizes within 4-8 days. Serial echocardiography findings show that the return of left ventricular function to a normal state correlates to clinical cardiorespiratory improvement.

Color-flow Doppler study findings show mitral incompetence, probably secondary to venom-induced dilated cardiomyopathy.

Myocardial perfusion scintigraphy can also be used to investigate the contractility and perfusion of the cardiac tissue. [30]

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