High voltage induced myocardial dysfunction with associated acute four-chamber dilated cardiomyopathy: A case report and review of the literature

Abstract

Electrical burns and lightening injuries are estimated to result in more than 3000 admissions to specialized burn units each year in the United States and comprise approximately 3–4% of all burn related injuries. The incidence has remained at a steady-state despite the implementation of safety protocols in the workplace and primarily affects young working men. Up to 40% of serious electrical injuries are fatal, resulting in an estimated 1000 deaths per year. High-voltage electrical injury (>1000 V) are truly devastating and cause long term morbidity in those who survive including extremity amputations, blindness, respiratory collapse and renal failure as a sequelae from the deep penetrating tissue destruction [1–5]. However, the most common cause of death continues to be cardiac arrest after acute arrhythmias at the scene of the incident secondary to either asystole or ventricular fibrillation [4,6]. In one postmortem study of four cases of accidental electrocution that resulted in immediate death, cardiac histopathology demonstrated transmural widespread focal necrosis and contraction band necrosis of the smooth muscle cells in the tunica media within the coronary arteries [7]. There are also numerous case reports in the literature describing