ST-segment elevation in anterior leads secondary to electric shock – a diagnostic dilemma

Anil Kumar Muniraju
Amit Kumar Rohila
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Ankur Sharma
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Rakesh Guna Shekar
Mahaveer Singh Rodha
Department of Trauma and Emergency, All India Institute of Medical Sciences, Jodhpur, India
Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India
Department of Trauma and Emergency, All India Institute of Medical Sciences, Jodhpur, India
Department of Trauma and Emergency, All India Institute of Medical Sciences, Jodhpur, India
Department of Trauma and Emergency, All India Institute of Medical Sciences, Jodhpur, India
Received: 4 March 2024 / Revised: 6 May 2024 / Accepted: 8 May 2024 / Published: 30 September 2024

Abstract

Introduction and aim. Electrical injuries can be life-threatening and prompt interventions can save lives. Cardiac complications like arrhythmias and sudden cardiac death are common after electric shock. Certain ECG abnormalities can persist after successfully reviving the patient which can mimic ST-Elevation occlusive myocardial infarction. This case report aims to inform the treating emergency physicians about this rare association of ST-Elevation in anterior leads after electric shock.

Description of the case. After obtaining proper consent from the patient, we describe here an interesting case of a 19-year-old boy who was presented to the emergency room with cardiac arrest after sustaining electrical injury. The patient was revived after cardiopulmonary resuscitation; ECG, as well as echocardiographic findings, were consistent with ST-elevation myocardial infarction of the anterior wall. A diagnostic dilemma was there between occlusive and non-occlusive causes of this condition. A coronary angiogram and conservative management of the patient helped in decision making and he was discharged with a Glasgow coma scale of 15/15 after recovery.

Conclusion. ST-Elevations in ECG can occur after electric shock injury and their cause is rarely due to occlusion of the coronaries. Hence thrombolysis in such cases is rarely needed and supportive management is required.

 

Cite 

Muniraju AK, Rohila AK, Sharma A, Shekar RG, Rodha MS. ST-segment elevation in anterior leads secondary to electric shock – a diagnostic dilemma. Eur J Clin Exp Med. 2024;22(3):698–701. doi: 10.15584/ejcem.2024.3.28.

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