What is the role of electrocardiography 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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Answer

Electrocardiography, if indicated, should be performed. ECG changes persist for 10-12 days before normalizing. ECG changes are observed in 63% of children who have been envenomated. Rhythm disturbances are not dose-dependent but are related to the venom composition. Note the following:

  • First-degree block - 10.2%

  • Bundle-branch block - 12.8%

  • Ventricular repolarization abnormalities - 15%

  • T-wave inversion - 39%

  • ST changes - 39%

  • QTc prolongation - 53%

  • Sinus tachycardia - Most common rhythm

  • A possible sequence of ECG changes has been noted. This sequence starts with bizarre, broad-notched, biphasic, peaked T waves with a beat-to-beat variation. This bizarre T wave is followed by the appearance of tiny Q waves and then atrioventricular dissociation with an accelerated junctional rhythm.


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