These signs and symptoms will usually manifest earliest. Not all signs and symptoms will necessarily develop, even with severe envenomation. These symptoms typically manifest within thirty minutes to four hours following the bite if envenomation occurred. Acute Renal Failure has been reported in a few cases of Black Mamba bites in humans as well as in animal models. Oliguria or Anuria with possible changes in urinary composition will herald the development of renal shutdown.
Dialysis is advised.
Changes in cardiovascular status result primarily from the effects of Circulatory Collapse and Shock, as well as vagal blockade resulting in Tachydysrhythmias. Pulse and pressure may initially be within normal limits, but may change with rapid onset cardiovascular collapse. Local tissue damage appears to be relatively infrequent and of minor severity in most cases of Black Mamba envenomation. Edema is typically minimal. Fang marks may be present as one or more well defined punctures, as a series of small lacerations or scratches, or there may not be any noticeable or obvious markings where the bite occurred.