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External cardioversion-related cardiac damage.

S Lee1, J P Veinot1, S Smith2

  • 1From Anatomical Pathology, Department of Laboratory Medicine, and the University of Ottawa Heart Institute at Ottawa Civic Hospital, Ottawa, Ontario, Canada; From Cardiology, and the University of Ottawa Heart Institute at Ottawa Civic Hospital, Ottawa, Ontario, Canada.

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|April 9, 2015
PubMed
Summary
This summary is machine-generated.

Electrical cardioversion can cause rare but significant heart injury, particularly in heart transplant patients with severe rejection. Pathologists must recognize this specific pattern of myocardial damage to avoid misdiagnosis.

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Area of Science:

  • Cardiology
  • Pathology
  • Transplantation Medicine

Background:

  • Iatrogenic cardiac injury is uncommon.
  • Electrical cardioversion is a medical procedure used to restore normal heart rhythm.

Purpose of the Study:

  • To describe a unique case of electrical cardioversion-induced cardiac injury.
  • To highlight the importance of recognizing this specific injury pattern in postmortem examinations.

Main Methods:

  • Case report of a 58-year-old male heart transplant recipient.
  • Review of clinical history, including severe acute rejection, heart failure, and atrial flutter.
  • Postmortem examination of cardiac tissue, including histopathological analysis.

Main Results:

  • The patient underwent multiple unsuccessful electrical cardioversions.
  • Postmortem examination revealed marked subepicardial wedge-shaped necrosis in the left ventricle.
  • Histological dating of the necrosis correlated with the timing of cardioversion attempts.

Conclusions:

  • Electrical cardioversion can lead to significant iatrogenic myocardial injury.
  • Pathologists must differentiate this injury from ischemic damage.
  • Awareness of this specific morphologic pattern is crucial for accurate diagnosis in post-transplant patients.