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.
Guinard
J P
JP
Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Chiolero
R
R
Buchser
E
E
Delaloye-Bischof
A
A
Payot
M
M
Grbic
A
A
Krupp
S
S
Freeman
J
J
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