01733nas a2200217   4500000000100000008004100001260004400042653001300086653001900099653003000118653001500148100001100163700001200174700001500186245007300201856008700274300000600361490000700367520112700374022001401501       2025                            d  bSpringer Science and Business Media LLC10aEtiology10aCardiomyopathy10aTakotsubo cardiomyopathy 10aSnakebites1 aAoki Y1 aSmith C1 aAriyoshi K00aAnother potential etiology for cardiac manifestation after snakebite  uhttps://tropmedhealth.biomedcentral.com/counter/pdf/10.1186/s41182-025-00709-5.pdf  a30 v533 a<p>This letter discusses the possibility of Takotsubo cardiomyopathy (TTC) as an alternative diagnosis in a recently reported case of acute myocardial infarction following a hump-nosed viper bite. The patient’s presentation, including delayed chest tightness, elevated troponin, ECG changes, and normal coronary arteries, coupled with complete recovery within 3 months, strongly suggests TTC. Multiple case reports have documented the association between snakebites and TTC, with proposed pathophysiological mechanisms including sympathetic surge from pain and stress, direct cardiotoxic effects of venom, and inflammatory mediators during envenomation. The excessive catecholamine response may trigger transient cardiac dysfunction characteristic of TTC. Recognizing TTC as a potential complication of snakebites has important clinical implications, as its management and prognosis differ from acute coronary syndrome. Understanding this association may enhance diagnostic approaches and treatment strategies in similar cases, particularly when normal coronary arteries and complete cardiac recovery are observed.</p>
  a1349-4147