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Cardiac manifestations following electrocution in children

Published online by Cambridge University Press:  18 August 2008

Alon Haim*
Affiliation:
Department of Cardiology, Soroka University Medical Center, Beer-Sheva, Israel
Nili Zucker
Affiliation:
Department of Cardiology, Soroka University Medical Center, Beer-Sheva, Israel
Aviva Levitas
Affiliation:
Department of Cardiology, Soroka University Medical Center, Beer-Sheva, Israel
Shaul Sofer
Affiliation:
Department of Pediatric Intensive Care Unit, Soroka University Medical Center, Beer-Sheva, Israel
Amos Katz
Affiliation:
Department of Cardiology Division, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Eli Zalzstein
Affiliation:
Department of Cardiology Division, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
Correspondence to: Alon Haim MD, Pediatric Cardiology Unit, Soroka University Medical Center, Beer-Sheva, Israel. Tel: 972 8 640 3050; Fax: 972 8 640 0665; E-mail: [email protected]

Abstract

Background

Electrical injury can result in a variety of cardiac abnormalities. We evaluate the cardiac effects in patients injured by electric shock and treated in our medical centre.

Methods

We reviewed retrospectively the findings in 52 children, aged from 7 months to 17 years, with a mean age of 10.1 ± 5.1 years, all evaluated and treated for accidental electric shock from January, 1992, through July, 2004. Relevant data regarding clinical presentation, electrocardiogram recording and cardiac enzymes was compiled. We also evaluated the echocardiographic findings, clinical course, treatment, and outcome.

Results

Syncope had been the presenting symptom in 17 children (33%), asystole in 1 patient, and ventricular fibrillation or tachycardia in 2 patients. Characteristic changes of acute ischaemia of the anterior wall on the basis of changes in the ST segments were noted in 2 patients. Total creatine phosphokinase was measured in 33 children (63%), and was elevated in 20. Creatine phosphokinase-MB was measured in 11 patients, and was abnormal in six (54%). Troponin was measured in three children, and was significantly high in one (33%). Cardiopulmonary resuscitation and mechanical ventilation for a significant period was necessary in 5 patients, of whom 4 (80%) survived. None of the survivors was left with any cardiac disability following the acute event.

Conclusions

Significant cardiac damage and complications are rare in children and young adults who survive incidental electrocution. Most of the cardiac events are observed during the acute phase and immediately subsequent to electrocution. No delayed complications are anticipated.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

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References

1. Rabban, JT, Blair, JA, Rosen, CL, Adler, JN, Sheridan, RL. Mechanism of pediatric electrical injury. Arch Pediatr Adolesc Med 1977; 151: 696700.CrossRefGoogle Scholar
2. Thomson, HG, Juckes, AW, Farmer, AW. Electrical burns to the mouth in children. Plast Reconstr Surg 1965; 35: 466477.CrossRefGoogle Scholar
3. DiVicenti, FC, Moncrief, JA, Pruitt, BA. Electrical shock: a review of 65 cases. J Trauma 1969; 9: 497507.Google Scholar
4. Garcia, CT, Smith, GA, Choen, DM, Fernandez, K. Electrical injuries in a pediatric emergency department. Ann Emerg Med 1995; 26: 604608.CrossRefGoogle Scholar
5. Jensen, PJ, Thomsen, PE, Bagger, JP, Norgaard, A, Baandrup, U. Electrical injury causing ventricular arrhythmias. Br. Heart J 1987; 57: 279283.CrossRefGoogle ScholarPubMed
6. Solem, L, Fischer, RP, Strate, RG. The natural history of electrical injury. J Trauma 1977; 17: 487492.CrossRefGoogle ScholarPubMed
7. Gifford, GH, Marty, AT, MacCollum, DW. The management of electrical mouth burns in children. Pediatrics 1971; 47: 113119.CrossRefGoogle ScholarPubMed
8. Bailey, B, Gaudreault, P, Thivierge, RL, Turgeon, JP. Cardiac monitoring of children with household electrical injuries. Ann Emerg Med 1995; 25: 612617.CrossRefGoogle ScholarPubMed
9. Shoenfeld, P, Savage, RW, Rupp, J. Atrial fibrillation and electrical appliance injury. Mil Med 1991; 156: 254255.CrossRefGoogle ScholarPubMed
10. Halperin, DS, Oberhansli, I, Rouge, JC. Cardiac and neurological impairments following electric shock in a young child. Helv Paediatr Acta 1983; 38: 159166.Google Scholar
11. Kok, LC, Mitchell, MA, Haines, DE, Mounsey, JP, DiMarco, JP. Transient ST elevation after transthoracic cardio version in patients with hemodynamically unstable ventricular tachyarrhythmia. Am J Cardiol 2000; 85: 878881.CrossRefGoogle Scholar
12. Vikenes, K, Omvik, P, Farstad, M, Nordrehaug, JE. Cardiac biochemical markers after cardio version of atrial fibrillation or atrial flutter. Am Heart J 2000; 140: 690696.CrossRefGoogle ScholarPubMed
13. Mullner, M, Oschatz, E, Sterz, F, et al. The influence of chest compressions and external defibrillation on the release of creatine kinase-MB and cardiac troponin T in patients resuscitated from out-of-hospital cardiac arrest. Resuscitation 1998; 38: 99105.CrossRefGoogle ScholarPubMed
14. Lund, M, French, JK, Johnson, RN, Williams, BF, White, HD. Serum troponins T and I after elective cardio version. Eur Heart J 2000; 21: 171173.CrossRefGoogle Scholar
15. Chen, EH, Sareen, A. Do children require ECG evaluation and inpatient telemetry after household electrical exposures? Ann Emerg Med 2007; 49: 6467.CrossRefGoogle ScholarPubMed