Keywords :
Coronary thrombosis autopsy, Electric injury, Myocardial infarction, Right ventricle
Citation Information :
Ghormade PS, Sahu K, Akhade SP. Right Ventricle Myocardial Infarction due to Coronary Thrombosis in a Patient after Sustaining Electric Injury. 2022; 1 (2):31-34.
Involvement of the heart is common in electric shock when the current follows a particular path. Electrical injuries affect the cardiovascular system in nearly 1/3rd of the patient, and myocardial infarction (MI) is a potential, although rare, consequence of electric shock. Deaths after an electric shock are immediate due to cardiac arrhythmias or brainstem dysfunction. However, anticipating cardiac events in the survivor patient is a challenging task. We have described a case of a 32-year-old female who sustained accidental electric shock due to contact with the live wire. The patient was revived on initial cardiopulmonary resuscitation (CPR). She survived for 30 hours after initiating treatment, and her electrocardiogram (ECG) revealed sinus tachycardia. She had an electric entry burn injury over the left thenar eminence and left thumb. Thrombotic occlusion or right coronary with transmural infarction of the anterolateral wall of the right ventricle was a prominent finding in the autopsy.
Gursul E, Bayata S, Aksit E, et al. Development of ST elevation myocardial infarction and atrial fibrillation after an electrical injury. Case Rep Emerg Med 2015;2015:953102. DOI: 10.1155/2015/953102
Kinney TJ. Myocardial infarction following electrical injury. Ann Emerg Med 1982;11(11):622–625. DOI: 10.1016/s0196-0644(82)80206-0
Waldmann V, Narayanan K, Combes N, et al. Electrical cardiac injuries: current concepts and management. Eur Heart J 2018;39(16):1459–1465. DOI: 10.1093/eurheartj/ehx142
Saukko P, Knight B. Knight's Forensic Pathology. London: Arnold; 2006.
Rosen CL, Adler JN, Rabban JT, et al. Early predictors of myoglobinuria and acute renal failure following electrical injury. J Emerg Med 1999;17(5):783–789. DOI: 10.1016/S0736-4679(99)00084-0
Solem L, Fischer RP, Strate RG. The natural history of electrical injury. J Trauma 1977;17(7):487–492. DOI: 10.1097/00005373-197707000-00001
Celebi A, Gulel O, Cicekcioglu H, et al. Myocardial infarction after an electric shock: a rare complication. Cardiol J 2009;16(4):362–364.
Jex-Blake. The Goulstonian lectures on death by electric currents and by lightning: delivered before the Royal College of Physicians of London. Br Med J 1913;1(2725):601–603. DOI: 10.1136/bmj.1.2725.601
Mboden LE, Newton CB. Myocardial infarction following electric shock. US Armed Forces Med J 1952;3(3):497–502.
Kinney TJ. Myocardial infarction following electrical injury. Ann Emerg Med 1982;11:622–625. DOI: 10.1016/s0196-0644(82)80206-0
Zehender M, Kasper W, Kauder E, et al. Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993;328(14):981–988. DOI: 10.1056/NEJM199304083281401
Killip T 3rd, Payne MA. High serum transaminase activity in heart disease. Circulatory failure and hepatic necrosis. Circulation 1960;21(5):646–660. DOI: 10.1161/01.CIR.21.5.646
James TN, Riddick L, Embry JH. Cardiac abnormalities demonstrated post-mortem in four cases of accidental electrocution and their potential significance relative to nonfatal electrical injuries of the heart. Am Heart J 1990;120(1):143–157. DOI: 10.1016/0002-8703(90)90171-s
Jacob S, Belli EV. Electric shock-induced coronary artery thrombosis and dissection. Ann Thorac Surg 2019;107(2):e105–e106. DOI: 10.1016/j.athoracsur.2018.06.013
Cooper MA. Emergent care of lightning and electrical injuries. Semin Neurol 1995;15(3):268–278. DOI: 10.1055/s-2008-1041032