ST Segment Elevation Myocardial Infarction Following a Crotalus horridus Envenomation

Abstract

Cardiac ischemia or myocardial infarction after pit viper envenomation is rare. Few case reports have been published, none describing cases reported after crotaline snake envenomation in the United States. We report a case of ST-segment elevation myocardial infarction (STEMI) occurring in a 73-year-old man after an envenomation by a juvenile canebrake rattlesnake (Crotalus horridus). The man was bitten on the left index finger and subsequently developed localized edema followed by hypotension, chest pain, and altered mental status. His initial electrocardiogram revealed ST-segment elevation in the inferior and lateral leads. His hospital course included emergent left heart catheterization with thrombectomy and cardiac stent placement. This case captures the unique medical situation involving the approach to treatment and management of a patient with a severe crotaline envenomation complicated by a STEMI.

Keywords: canebrake; rattlesnake.