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The Korean Journal of Medicine 2007;73(1): 92-95.
증례 : 지네 교상에 의한 미만성 관상동맥 연축 1예
이기훈, 정명호, 안영근, 김주한, 홍영준, 강정채
Department of Internal Medicine, Gyeong-Sang National University College of Medicine, Jinju, Korea
Coronary artery spasm induced by a centipede bite
Gi Hoon Lee, Myung Ho Jeong, Young Keun Ahn, Ju Han Kim, Young Joon Hong, Jung Chaee Kang
경상대학교 의과대학 내과학교실
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.(Korean J Med 73:92-95, 2007)
Keywords: Centipede, Spasm, Coronary Disease
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