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Takotsubo cardiomyopathy following lightning strike
B K Dundon1, R Puri, D P Leong
1Cardiovascular Investigation Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia. benjamin.dundon@adelaide.edu.au
Emergency Medicine Journal : EMJ
|June 25, 2008
Summary
Lightning strikes can cause severe heart problems like Takotsubo cardiomyopathy, a temporary heart condition. This case highlights the potential for serious cardiac injury from lightning, even in healthy individuals.
Area of Science:
- Cardiology
- Environmental Medicine
- Emergency Medicine
Background:
- Lightning strike is a leading environmental cause of sudden cardiac death.
- Cardiac injuries from lightning strikes can range from electrocardiographic changes to severe organ system damage.
- Significant electrical cardiac trauma is considered uncommon.
Observation:
- A case of severe acute cardiomyopathy in a "Takotsubo" distribution is presented following a lightning strike.
- The patient was a previously healthy 37-year-old woman who experienced cardiogenic shock.
- Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is characterized by temporary cardiac dysfunction.
Findings:
- Takotsubo cardiomyopathy can mimic acute myocardial infarction with ECG changes and minimal cardiac enzyme release.
- This condition has a significant female predilection (up to 90% of cases).
- While left ventricular function recovery is typical, rare complications like cardiac rupture can occur.
Implications:
- Lightning strike-induced cardiac injury can lead to serious, though usually transient, cardiac sequelae.
- The incidence of subclinical myocardial mechanical dysfunction following lightning strikes remains unknown.
- This case underscores the importance of seeking shelter during thunderstorms to prevent potential cardiac trauma.
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