Shocked into Shock: Cardioversion-Induced Shock with Multi-Organ Injury

Abstract

Direct current cardioversion (DCCV) is an increasingly prevalent procedure to disrupt abnormal rhythms and restore normal sinus rhythm. While considered a relatively safe procedure, complications can be severe. We add to the emerging research surrounding delayed presentations of cardiogenic shock post-DCCV. Together with a review of the current literature, we extrapolate that a combination of post-conversion cardiac shifts, myocardial stunning, and a unique cardioversion stress-induced cardiomyopathy contributed to this occurrence. To our knowledge, this represents one of only a few examples of delayed, non-arrhythmic, cardioversion-induced cardiogenic shock and the first to cause the combination of non-ST elevation myocardial infarction, acute liver injury, and acute kidney injury. Our case adds to the growing body of research highlighting this rare, but serious consequence of direct current cardioversion.