Takotsubo cardiomyopathy following lightning strike

Area of Science:

• Cardiology
• Environmental Medicine
• Emergency Medicine

Background:

• Lightning strike is a leading environmental cause of sudden cardiac death.
• Cardiac injuries from lightning can range from electrocardiographic changes to rare instances of severe trauma.
• Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is typically associated with emotional or physical stress.

Purpose of the Study:

• To present a case of severe acute cardiomyopathy in a Takotsubo distribution following a lightning strike.
• To discuss the potential for significant cardiac sequelae from lightning-induced electrical trauma.
• To highlight the underrecognized association between lightning strikes and Takotsubo cardiomyopathy.

Main Methods:

• Case report of a previously healthy 37-year-old woman.
• Clinical presentation, electrocardiographic findings, and cardiac enzyme levels were assessed.
• Diagnostic criteria for Takotsubo cardiomyopathy were applied in the context of lightning strike injury.

Main Results:

• The patient developed cardiogenic shock secondary to acute cardiomyopathy in a Takotsubo pattern after a lightning strike.
• Electrocardiographic changes mimicked acute myocardial infarction, with minimal elevation of cardiac-specific enzymes.
• This presentation is rare, as significant electrical cardiac trauma from lightning is uncommon.

Conclusions:

• Lightning strike can precipitate Takotsubo cardiomyopathy, a serious but usually transient cardiac condition.
• While recovery of left ventricular function is typical, rare catastrophic complications can occur.
• This case underscores the potential for significant cardiac injury from lightning and the importance of thunderstorm safety.