Myocardial injury after electrical burns: Short and Long term study

Abstract

Miscellaneous cardiac abnormalities can occur after electrical burns. The long term outcomes are still unknown. We studied 10 patients, 9 of whom suffered high-voltage electrocution, and one of whom was struck by lightning. Serial electrocardiograms (ECG) and serum MB creatine phosphokinase isoenzyme (MB-CPK) activities were obtained during their stay in hospital. ECG and thallium 201 cardiac scintigraphy at rest, as well as echocardiograms were obtained in all patients 4 to 48 months after discharge. In hospital, 9 patients showed one or more abnormal findings at physical examination (4 cases), ECG (8 cases), MB-CPK (1 case). At long term follow-up, 5 patients had one or more myocardial functions or conduction abnormalities, with or without symptoms. One patient had compensated heart failure. Nine patients were asymptomatic. Abnormal ECG findings persisted in 3 patients. Three cardiac scans showed evidence of regional myocardial hypoperfusion. Decreases in left ventricular indices measured by echocardiogram were found in 3 patients. We conclude that high-voltage electrocution is associated with a high incidence of cardiac abnormalities, which may persist. Long term evaluation, requiring cardiac T1 201 scintigraphy and echocardiogram, may be justified.

Cardiac pathology in death from electrocution

“…direct, splash and ground strike). The direct type of lightning injury can result in "myocardial injury" (evidenced by a significant increase in CPKmb), depression of the ST-T tract, alterations in ventricular kinetics visible with echocardiography and also lengthening of the QT interval [20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Electric shock: Cardiac effects relative to non fatal injuries and post-mortem findings in fatal cases

“…In a long term follow-up, 5 patients had one or more abnormalities in their cardiac conduction system and function, with or without symptoms; one patient developed cardiac failure; in three patients ECG anomalies persisted and anomalies in the left ventricular functions were revealed through an echocardiography. The authors thus conclude that ''high voltage electrocution is associated with a high incidence of cardiac abnormalities, which may persist'' [25].…”

Tachycardia following low-tension electrocution

“…High-tension shocks (>1000 Volts) from lightening strikes and overhead power cables cause severe skin burns and may cause cardiac arrest usually due to asystole 1. High-voltage injuries lead to a high incidence of cardiac abnormalities, up to 30% of those with cardiac arrhythmias on presentation have long-term reduction in cardiac function measured by echocardiography 2. Changes in cardiac conduction including complete heart block, and prolongation of the QT interval suggest that electric shocks can significantly modify intracardiac conduction 3…”