APPROXIMATELY 150 people are killed by lightning annually in the United States, and an estimated twice that number are injured.1,2Death in most is due to either respiratory arrest or cardiac arrhythmias. Although minor ECG changes are frequent in survivors of lightning injury, clinical evidence of actual myocardial damage is uncommon. We report the case of a young man struck by lightning who was initially asymptomatic and appeared to have suffered only mild superficial burns. An ECG, however, suggested acute myocardial injury, and three hours later acute pulmonary edema developed. Subsequent hemodynamic investigations confirmed the presence of myocardial damage. Report of a Case During field training maneuvers, three young soldiers were asleep in their tent when struck by lightning. All were stunned and suffered minor first- and second-degree burns to the neck, chest, and back, but none lost consciousness. When seen in the emergency room, all were alert, well