Myocardial injury after electrical burns: short and long term study.
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.
Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
J P
JP
Guinard
R
R
Chiolero
E
E
Buchser
A
A
Delaloye-Bischof
M
M
Payot
A
A
Grbic
S
S
Krupp
J
J
Freeman
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002058:Burns, Electric / Q000150:complications*; D003402:Creatine Kinase / Q000097:blood; D004452:Echocardiography; D004556:Electric Injuries / Q000150:complications; D004562:Electrocardiography; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007527:Isoenzymes; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D011877:Radionuclide Imaging; D013997:Time Factors
D007527:Isoenzymes; D003402:Creatine Kinase