Development of ST Elevation Myocardial Infarction and Atrial Fibrillation after an Electrical Injury

Abstract

Electrical energy is a type of energy that is commonly used in daily life. Ventricular premature beats, ventricular tachycardia, ventricular fibrillation, atrial tachycardia, atrial fibrillation, bundle branch blocks, and AV block are arrhythmic complications that are encountered in case of electric shocks. Myocardial infarction is one of the rarely seen complications of electric shocks yet it has fatal outcomes. Coronary arteries were detected to be normal in most of the patients who had myocardial infarction following an electric shock. So, etiology of myocardial infarction is thought to be unrelated to coronary atherosclerosis in these cases. Coronary artery vasospasm is thought to be the primary etiological cause. In our case report, we presented a patient who developed ST elevation MI with atrial fibrillation after an electric shock.

New insights on the "DC shock-reperfusion"in ST elevationmyocardialinfarction: killingtwobirdswithonestone?

“…Therefore, ST-segment elevation without a dynamic and evolving acute myocardial infarction underscores the need to consider other causes of ST-segment elevation. However, some ST elevation and primary ventricular fibrillation combination reports have been explained by coronary spasm or only direct current shock-induced ST elevation ( 5 ), but the possibility of our hypothesis deserves consideration in these cases. We can speculate that urgent direct current shock may not only be an effective treatment of fatal arrhythmic primary ventricular fibrillation but might also have a role in the re-establishment of spontaneous circulation by the dissolution of the coronary thrombus.…”

Acute Inferolateral Myocardial Infarction Due to Electrical Injury

“…It has been suggested that ischemia and necrosis due to electrical injury mostly affect the distribution of the right coronary artery because of its proximity to the anterior chest wall (9). Gursul et al reported inferior ST elevation MI and atrial fibrillation after an electrical shock (10). The patient had normal coronary arteries at angiogram.…”

Infarto de miocardio ST elevado después de un trauma eléctrico: Una rara complicación.

“…La coronariografía es de elección para evaluar el mecanismo etiológico subyacente y contribuye a guiar la terapia, ya que se han reportado en la mayoría de casos arterias coronarias normales o sin lesiones obstructivas, siendo el vasoespasmo coronario el mecanismo principal (5,6) . Así, la angioplastia percutánea estaría indicada solo en aquellos casos en que se encuentren lesiones coronarias oclusivas como mecanismo responsable (4,7,8) .…”

“…Las arritmias son las complicaciones de mayor frecuencia, siendo las más frecuentes la taquicardia sinusal, las extrasístoles ventriculares, la fibrilación/flutter auricular, la taquicardia ventricular o la fibrilación ventricular (2) . La injuria miocárdica, determinada por una elevación de las troponinas cardiacas (3) , puede producirse por diferentes mecanismos como: Injuria directa, injuria mediada por liberación de catecolaminas a la microcirculación, reducción del flujo coronario secundario a hipotensión generalizada, espasmo/trombosis coronaria, o contusión miocárdica relacionada a la reanimación cardiopulmonar (4) . La presencia de injuria miocárdica con evidencia clínica de isquemia miocárdica aguda, define el infarto agudo de miocardio.…”