RT Journal Article
SR Electronic
T1 Junctional bradycardia caused by ciguatera intoxication
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e229354
DO 10.1136/bcr-2019-229354
VO 12
IS 5
A1 Rajendra Raman
A1 Sarah Coppes
A1 Tessa Hellingman
A1 Casper Laclé
YR 2019
UL http://casereports.bmj.com/content/12/5/e229354.abstract
AB Ciguatera is a common but underreported tropical disease caused by the consumption of coral reef fish contaminated by ciguatoxins. Gastrointestinal and neurological symptoms predominate, but may be accompanied by cardiovascular features such as hypotension and sinus bradycardia. Here, we report an unusual case of junctional bradycardia caused by ciguatera in the Caribbean; to our knowledge, the first such report from the region. An increase in global sea temperatures is predicted to lead to the spread of ciguatera beyond traditional endemic areas, and the globalisation of trade in coral reef fish has resulted in sporadic cases occurring in developed countries far away from endemic areas. This case serves as a reminder to consider environmental intoxications such as ciguatera within the differential diagnosis of bradycardias.