Cardiac disease developed several days to weeks after resolution of lo
cal inflammation caused by envenoming by Vipera palaestinae in two hor
ses. In one horse (case A), referred to the hospital for recurrent abd
ominal pain 8 days after envenoming, a tachyrhythmia was detected; ven
tricular premature depolarizations were diagnosed by ECG. A second hor
se (case B) was found dead without premonitory signs 60 days after env
enoming. In both horses, there was extensive necrosis of cardiac ventr
icular tissues.