Korean J Med.  2007 Jul;73(1):92-95.

Coronary artery spasm induced by a centipede bite

• Lee GH
• Jeong MH
• Ahn YK
• Kim JH
• Hong YJ
• Kang JC

Abstract

The centipede is an elongated and multi-segmented arthropod with a venom apparatus that consists of modified legs on either side of the body just behind the head. Generally, centipede envenomation causes local tissue swelling, redness, pruritus, swollen and painful lymph nodes, headache, nausea, vomiting and anxiety. Adverse systemic reactions such as acute renal failure, rhabdomyolysis and acute myocardial infarction have been associated with centipede bite. We experienced a case of a 57-year-old man who complained of severe chest pain after a centipede (20 cm in length) bite. The electrocardiogram recorded at the emergency medical center showed ST-T changes in the precordial leads. The levels of cardiac enzyme were not elevated [creatine kinase (CK) 101 U/L (35~172), CK-MB 5.1 U/L (2.3~9.5), troponin I 0.06 ng/mL (0~0.05), troponin T 0.02 ng/mL (0~0.1)]. He had a history of percutaneous coronary intervention in the left circumflex artery under the diagnosis of acute myocardial infarction 4 years ago. The emergency coronary angiogram revealed severe diffuse coronary artery spasm in the left coronary artery, which was improved after intracoronary nitroglycerin injection, and patent previously placed stent in the left circumflex artery was noted. He improved after medical treatment and was discharged on the eleventh day without any remained subjective symptoms.

Keyword

Centipede; Spasm; Coronary Disease

MeSH Terms

Acute Kidney Injury
Anxiety
Arteries
Arthropods
Chest Pain
Coronary Disease
Coronary Vessels*
Diagnosis
Electrocardiography
Emergencies
Head
Headache
Humans
Leg
Lymph Nodes
Middle Aged
Myocardial Infarction
Nausea
Nitroglycerin
Percutaneous Coronary Intervention
Phosphotransferases
Pruritus
Rhabdomyolysis
Spasm*
Stents
Troponin I
Troponin T
Venoms
Vomiting
Nitroglycerin
Phosphotransferases
Troponin I
Troponin T
Venoms