TY  - JOUR
PY  - 2019//
TI  - Junctional bradycardia caused by ciguatera intoxication
JO  - BMJ case reports
A1  - Raman, Rajendra
A1  - Coppes, Sarah
A1  - Hellingman, Tessa
A1  - Laclé, Casper
SP  - e229354
EP  - e229354
VL  - 12
IS  - 5
N2  - 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.<br><br>© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.<p />  <p>Language: en</p>
LA  - en
SN  - 1757-790X
UR  - http://dx.doi.org/10.1136/bcr-2019-229354
ID  - ref1
ER  -