Echocardiographic Observations in Survivors of Acute Electrical Injury

Echocardiographic Observations

Although it is well known that cardiopulmonary arrest is the main cause of immediate death due to electrical injury, there is a paucity of information concerning the cardiovascular sequelae in survivors of the acute event. Enzyme changes consistent with myocardial necrosis have been reported. However, these may be difficult to interpret in the context of extensive noncardiac muscular damage at the time of the original injury and/or during resuscitation. Electrocardiographic patterns of myocardial infarction have also been described immediately following the electrical insult. These typically normalize dramatically and in long-term survivors have been reported to be totally reversible. Similarly, the single previous case report describing left ventricular function following acute electrical injury also suggested that there is total recovery of left ventricular function.

In this report we describe the two-dimensional echocardiographic observations in two young men who suffered cardiac arrest when they touched high tension wires. In contrast to the previously reported case of totally reversible left ventricular dysfunction, these two patients had persistent functional abnormalities. In one, there was dramatic recovery of function of basal and midventricular segments but persistent apical dyskinesis. In the second, there was severe persistent biventricular dysfunction. In com-bination with the previously reported case, these two suggest that there is marked variability in the degree of cardiac dysfunction that persists after acute electrical injury.
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