Myocardial injury due to lightning

Area of Science:

• Cardiology
• Neurology
• Forensic Medicine

Background:

• Lightning strikes are rare but can cause severe, life-threatening injuries.
• Understanding the pathophysiology of lightning-related trauma is crucial for medical management.

Observation:

• A 27-year-old male sustained a lightning strike injury while near a tree.
• Immediate loss of consciousness and ventricular fibrillation were observed upon emergency physician arrival.
• Clinical presentation evolved to hypoxemic brain damage despite initial resuscitation efforts.

Findings:

• External findings included arborescent skin marks, contrasting with severe internal thermal damage.
• Autopsy revealed extensive thermal damage to pectoral and cardiac musculature.
• Histological examination confirmed severe acute myocardial infarction affecting nearly all myocardial regions.

Implications:

• Lightning strikes can cause profound cardiac damage, including myocardial infarction, even with seemingly minor external injuries.
• Electrical trauma necessitates thorough cardiac and neurological evaluation.
• This case underscores the critical importance of autopsy in elucidating the full extent of internal injuries from lightning strikes.