Cardiac abnormalities demonstrated postmortem in four cases of accidental electrocution and their potential significance relative to nonfatal electrical injuries of the heart

James, Thomas N.; Riddick, LeRoy; Embry, Joseph H.

doi:10.1016/0002-8703(90)90171-s

Cited by 61 publications

(28 citation statements)

References 58 publications

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“…These include the induction of coronary artery spasm, 3) catecholamine-mediated injuries, 3) direct thermal injury, 4) ischemia secondary to arrhythmia-induced hypotension, 5) and coronary artery ischemia as part of a generalized vascular injury. 5) Takotsubo-shaped hypokinesis of the left ventricle has been documented in patients in Japan; it is characterized by an apical wall motion abnormality, sometimes in the absence of coronary artery disease. 6) Akashi, et al 7,8) reported takotsubo-shaped hypokinesis following an episode of polymorphic ventricular tachycardia especially with a short coupling interval, and following an episode of pneumothorax of the left lung.…”

Section: Discussionmentioning

confidence: 99%

“…Although electrical currents can damage the walls of the coronary arteries, there may also be a direct thrombogenic effect. [3][4][5] Ekoe, et al 15) reported a case of cardiogenic shock complicated by disseminated intravascular coagulation caused by lightning. Furthermore, it has been reported that direct current shocks cause cardiac dysfunction because of circulatory disturbance in endothelial and epicardial microvessels.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Takotsubo-Shaped Hypokinesis of the Left Ventricle Caused by a Lightning Strike

Hayashi¹,

Yamada²,

Agatsuma³

et al. 2005

Int. Heart J.

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SUMMARYA 62-year-old woman was struck by lightning while on a mountain and fortunately did not suffer burns or unconsciousness. She stayed at a mountain lodge overnight and was taken to our hospital by helicopter the next day. Upon admission, electrocardiography showed ST segment elevation indicating acute lateral myocardial infarction, and echocardiography showed takotsubo-shaped hypokinesis of the left ventricle indicating an apical aneurysm. Her serum escaped enzyme levels were increased, as is typical in cases of myocardial infarction, however, she did not complain of cardiac symptoms. Coronary arteriography performed 4 days after admission showed a normal coronary artery while left ventriculography showed apical akinesia. An echocardiogram obtained 2 days later showed resolution of the LV wall motion abnormality. This is the first reported case of takotsubo cardiomyopathy caused by lightning. Takotsubo-shaped hypokinesis is not described as a complication of lightning-induced cardiac injury and its pathogenesis remains controversial. (Int Heart J 2005; 46: 933-938) Key words: Takotsubo-shaped hypokinesis, Lightning, Catecholamine-induced cardiomyopathy CASE REPORTA 62-year-old woman was admitted to our hospital in July 2004 after being struck by lightning. Before the event, she had been healthy, and the results of electrocardiography (ECG) performed at her annual health examinations were normal. She was climbing Mt. Hakuba (2932 meters) with two other people when her walking-stick was struck by lightning. All three stayed at a mountain lodge that night, and the next day they were brought to our hospital by helicopter. Upon admission, the woman complained of a slight headache, but there were no cardiac symptoms. However, one of her companions had sustained second-degree burns From the

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case of Takotsubo-Shaped Hypokinesis of the Left Ventricle Caused by a Lightning Strike

Hayashi¹,

Yamada²,

Agatsuma³

et al. 2005

Int. Heart J.

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“…and the ECG showed features of inferior wall 'Q' wave infarction. Inferior wall involvement and absence of precordial pain, have been reported [3,7]. Congestive cardiac failure is uncommon following electrical injury.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Injury in Electrical Burns

Piplani

Sethi

2001

Medical Journal Armed Forces India

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“…Also, lighting can certainly cause asystole through nerve or cardiac nodal damage and lightning is, indeed, a DC shock. 47,48 VT and Delayed Cardiac Arrest A speculation -that has been raised to attempt to argue for a long gap between an electrical exposure and VFis that the electrical current induced an intermediate VT. Important definitions: 1.…”

Section: Asystole From Direct Currentmentioning

confidence: 99%

Essentials of low-power electrocution: Established and speculated mechanisms

Kroll

Fish

Lakkireddy

et al. 2012

2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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-Even though electrocution has been recognizedand studied -for over a century, there remain several common misconceptions among medical professional as well as lay persons. This review focuses on "low-power" electrocutions rather than on the "high-power" electrocutions such as from lightning and power lines. Low-power electrocution induces ventricular fibrillation (VF). We review the 3 established mechanisms for electrocution: (1) shock on cardiac Twave, (2) direct induction of VF, and (3) long-term high-rate cardiac capture reducing the VF threshold until VF is induced. There are several electrocution myths addressed, including the concept -often taught in medical schoolthat direct current causes asystole instead of VF and that electrical exposure can lead to a delayed cardiac arrest by inducing a subclinical ventricular tachycardia (VT). Other misunderstandings are also discussed. 1

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Cardiac abnormalities demonstrated postmortem in four cases of accidental electrocution and their potential significance relative to nonfatal electrical injuries of the heart

Cited by 61 publications

References 58 publications

A Case of Takotsubo-Shaped Hypokinesis of the Left Ventricle Caused by a Lightning Strike

A Case of Takotsubo-Shaped Hypokinesis of the Left Ventricle Caused by a Lightning Strike

Myocardial Injury in Electrical Burns

Essentials of low-power electrocution: Established and speculated mechanisms

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