Electric Shock–Induced Coronary Artery Thrombosis and Dissection

Jacob, Samuel; Belli, Erol V.

doi:10.1016/j.athoracsur.2018.06.013

Cited by 4 publications

(4 citation statements)

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“…Electric shock–induced injuries are rarely reported. To our knowledge, the only previously reported cases of cardiac damage are from Akci et al, who reported a case of myocardial infarction after electric shock, and from Jacob and Belli at our institution, who reported a case of electric shock–induced coronary artery thrombosis and dissection requiring coronary artery bypass grafting (case 1 in this series). The ideal treatment for coronary damage from electrical shock is not known.…”

Section: Discussionmentioning

confidence: 60%

Electric shock–induced cardiac injuries requiring surgical intervention: Case series and a brief review

et al. 2019

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Background: Electric shock-induced cardiac injuries, such as myocardial infarction, thrombosis, and dissection, are rare. Few cases have been previously reported. The right coronary artery is most often affected because of its proximity to the chest wall. Aims:To study the extend of electrical injuries on cardiac tissues and its surgical management. Materials and Methods:We conducted a retrospective study on our patients in the last five years, looking for cardiac electrical injuries treated surgically in our department, we identified three cases.Result: Our three-case series, reported herein, showed that multiple cardiac tissues are susceptible to electrical injuries, specifically the left coronary artery, inferior vena cava, and right ventricular free wall. In our series, the first patient was a 32-year-old man with triple vessel thrombosis and dissection who survived the electric shock. The second patient was a 23-year-old man who had an inferior vena cava burn and bruising; his heart was used for transplantation. After the transplant, the recipient had a left coronary artery dissection and underwent coronary artery bypass grafting.The third patient was a 30-year-old man (potential heart donor) who had a hematoma of the right ventricular free wall, possible coronary artery dissection, inferior vena cava bruising, and tissue damage. His heart was not used for transplant because of quality concerns. Conclusion:We recommend that any person who sustains high voltage (500 V or more) electric shock should be evaluated carefully in the emergency department, including with echocardiography and cardiac catheterization, if indicated, to determine the extent of the injury and the viability of the heart, for patients who do not survive as a donor organ. K E Y W O R D S cardiac injuries, coronary artery dissection, coronary artery thrombosis, electrocution Abbreviations: AC, alternating current; ECMO, extracorporeal membrane oxygenation; IMA, internal mammary artery; LAD, left anterior descending.How to cite this article: Jacob S, Landolfo KP, El-Sayed Ahmed MM, Thomas M, Makey IA, Pham SM. Electric shock-induced cardiac injuries requiring surgical intervention: Case series and a brief review. J Card Surg. 2020;35:488-491.

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Section: Discussionmentioning

confidence: 60%

Electric shock–induced cardiac injuries requiring surgical intervention: Case series and a brief review

et al. 2019

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“…Electrical injury can be fatal owing to complications such as ventricular fibrillation or coronary artery thrombosis and dissection. 5 Guidelines recommend 12-lead electrocardiography and 24-h monitoring after an electrical injury if the patient has any risk factors for arrhythmias. 6 Their necessity and the duration of cardiac monitoring are topics of debate.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the risks of arrhythmia following electrical injury: Two cases of electrical injuries in the upper limbs

Jingo

Kondo

Hirano

et al. 2020

SAGE Open Medical Case Reports

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Electrical injuries induce ventricular arrhythmias, which are lethal. Therefore, it is important to evaluate the risk of arrhythmias at initial presentation to the emergency department in cases of electrical injuries. Here, we report two cases with electrical injuries, where current flowed between the upper limbs, requiring 24-h hospitalization for arrhythmia monitoring. The patients were 57- and 30-year-old men, who sustained separate electrical injuries (6600 V, line voltage), with current flow from one hand to the other. They did not develop any ventricular arrhythmias during hospitalization and were discharged. The risk for ventricular arrhythmias is lower for electrical injuries occurring between the upper limbs than for those occurring between the upper and lower limbs. We conclude that 24-h hospitalization for monitoring of patients with electrical injuries of the upper limbs may be sufficient.

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“…The exact mechanism for massive coronary artery thrombosis and dissection was not understood. 14 Vascular damage occurs more in the media, possibly because of the blood flow diffusion of heat away from the intima. Intimal damage may result in either immediate or delayed thrombosis or vascular occlusion as edema and clots form on the damaged internal surface of vessels.…”

Section: Autopsy Findingsmentioning

confidence: 99%

Right Ventricle Myocardial Infarction due to Coronary Thrombosis in a Patient after Sustaining Electric Injury

Ghormade¹,

Sahu²,

Akhade³

2022

Indian Journal of Critical Care Case Report

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A previously healthy, 32-year-old woman accidentally came in contact with a live wire and got an electric shock (alternative current: 220 V, 50 Hz) at home while she was putting washed clothes for drying on the balcony on a metal wire. The victim was unaware that the loose end of the metal wire was in touch with the body of a running air cooler. The cooler had a faulty electric supply that led to the flow of electric current in its metal body. Hence, the victim accidentally sustained an electric shock and then fell down on the cemented floor and got unconscious. She was immediately hospitalized. The patient was revived after CPR. The patient was intubated and kept on ventilatory support. Vital parameters at the time of examination were Glasgow coma scale 03/15, pulse 148/min, blood pressure 180/100 mm Hg after continuous noradrenaline and adrenaline support, saturation of peripheral oxygen (SpO 2 ) 92% on the Bain circuit, and random blood sugar 268 mg/dL. In addition to the inotropic support, the patient was also given antibiotics and sodium bicarbonate to treat acidosis.The ECG showed sinus tachycardia. Electroencephalogram was performed on the patient, and it showed low amplitude HigHligHtsElectricity can cause vascular injury by damaging arterial walls. Coronary thrombosis can occur after electric shock. However, MI in the right ventricle due to right coronary thrombosis is a rare finding. Hence, during cardiac monitoring of patients having electric shock, physicians must always remember the possibility of such cardiac events.

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Electric Shock–Induced Coronary Artery Thrombosis and Dissection

Cited by 4 publications

References 4 publications

Electric shock–induced cardiac injuries requiring surgical intervention: Case series and a brief review

Electric shock–induced cardiac injuries requiring surgical intervention: Case series and a brief review

Evaluating the risks of arrhythmia following electrical injury: Two cases of electrical injuries in the upper limbs

Right Ventricle Myocardial Infarction due to Coronary Thrombosis in a Patient after Sustaining Electric Injury

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