PP100 SPIDERMAN WITH COMPLETE HEART BLOCK

Abstract

Spider bites are not all harmful to humans, but some species can cause medically significant complications including local or generalized pain with non-specific systemic effects. Some cases with autonomic, neurologic and skin manifestation have been reported. However, cardiovascular manifestation such as myocarditis is very rare. We reports a rare case of transient complete heart block after a spider bite in a young gentleman with unremarkable medical background. He complained of minimal pain over the bitten site as well as slight central chest discomfort. He was vitally stable but his electrocardiogram (ECG) recorded a complete heart block in our Emergency and Trauma Department (ETD) and was subsequently admitted for further observation. Despite raised Creatine Kinase, all his other investigations including echocardiogram were insignificant. He was eventually discharged after uneventful observation with resolution of complete heart block. Cases with cardiovascular complication after spider bite been reported before such as Widows spider, Latrodectus spp. bite which can cause reversible myocarditis. The mechanism of myocardial injury is still unclear. However transient complete heart block after spider bite has not been reported so far and our case is the very first case up to the time of writing. Complete heart block after spider bite is rarely encountered with uncertain prognosis even though our patient was discharged well. Baseline ECG for all cases bitten by spider should be made mandatory to elicit this potentially lethal and treatable complication.