Does black widow spider bite the heart?

• Published in: Progress in pediatric cardiology 2024-09, Vol.74, p.101728, Article 101728
• Main Authors: Alizadeh, Behzad, Bahrami Taghanaki, Pegah, Ghiasi, Shirin Sadat, Nikrouh, Elham, Pourali, Ghazaleh, Ghamsari, Anahita Alizadeh, Rahimpour, Feisal
• Format: Article
• Language: English
• Subjects: Bite; Black widow spider; Cardiovascular manifestation; Myocarditis
• ISSN: 1058-9813
• DOI: 10.1016/j.ppedcard.2024.101728

Black widow spider (BWS) bites account for 0.5 % of global poisonings and 21 % of poisonings in North-East Iran. In addition to local reactions, systemic cardiovascular manifestations are likely to occur. This study aims to present cases of patients who experienced cardiac symptoms after being envenomed by BWS. A descriptive retrospective cross-sectional evaluation was conducted on all patients who were bitten by a BWS in 2020 and presented with cardiac manifestations. They were referred to our tertiary pediatric cardiology center in Mashhad, Iran for evaluation. All accessible variables including history, physical examination, laboratory tests prioritizing cardiology, as well as electrocardiography and echocardiography findings, were evaluated. Six patients, ranging in age from 5.5 to 13 years old, were bitten by BWS. None of the patients had a past or drug history and were admitted due to pain complaints at various bite sites that radiated in different directions. Four patients showed signs of tachycardia, and two showed hypertension, but no signs of infection were observed. Half of the patients experienced systemic complications. Upon arrival at the hospital, four patients showed elevated CKMB levels, which decreased during their hospitalization. Troponin I and N-Terminal Pro B-type Natriuretic Peptide levels were high in all patients. One patient with unstable hemodynamics showed pro-BNP over 35,000. T wave inversion was observed in six patients, ST segment depression in three patients, and ST-segment elevation in one patient, with overlap between them. Taking notice of cardiovascular presentations after a BWS bite is considerable. •In addition to local reactions, Black widow spider (BWS) bites may produce systemic cardiovascular presentations•Nonspecific ECG presentations might be associated.•Therefore paying attention for cardiovascular complaints after a BWS bite is significant.