title: High-tension electrical injury to the heart as assessed by radionuclide imaging.
abstract: To evaluate cardiac complications associated with electrical injury, 7 patients with high-tension electrical injury (6,600 V alternating current) underwent 201Tl and 123I-metaiodobenzylguanidine (MIBG) imaging in addition to conventional electrocardiographic and echocardiographic assessments. Electrocardiography showed transient atrial fibrillation, second degree atrioventricular block, ST-segment depression, and sinus bradycardia in each patient. Echocardiography showed mild hypokinesis of the anterior wall in only 2 patients, but 201Tl and 123I-MIBG myocardial scintigraphy showed an abnormal scan image in 6/7 and 5/6 patients, respectively. Decreased radionuclide accumulation was seen primarily in areas extending from the anterior wall to the septum. Decreased radionuclide accumulation was smaller in extent and milder in degree in 123I. MIBG than in 201Tl imaging. These results suggest that even in patients without definite evidence of severe cardiac complications in conventional examinations, radionuclide imaging detects significant damage due to high-tension electrical injury, in which sympathetic nerve dysfunction might be milder than myocardial cell damage.
authors.affiliation: Department of Internal Medicine II, Tokyo Medical University, Kasumigaura Hospital, Ibaraki, Japan. . iino@tokyo-med.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Iino
authors.forename: Taishiro
authors.initials: T
authors.lastname: Chikamori
authors.forename: Tsuguhisa
authors.initials: T
authors.lastname: Hatano
authors.forename: Takayuki
authors.initials: T
authors.lastname: Morishima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hida
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Yanagisawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Usui
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kamada
authors.forename: Katsueki
authors.initials: K
authors.lastname: Watanabe
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D004452:Echocardiography; D004556:Electric Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D006321:Heart / Q000000981:diagnostic imaging*; D006335:Heart Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013793:Thallium
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; C027549:thallium chloride; D013793:Thallium