Background: Lightning strike is a natural, unavoidable and unpredictable celestial phenomenon.
Ventricular fibrillation and cardiac arrest due to depolarisation of cardiac myocardium is the most
common cause of death after an episode of lightening. Around 70% victims survive from the episode of
direct lightening injury. However splash of lightning leaves deep electrocardiographic imprints with
devastating clinical sequelae in the survivors.
Objective: To assess electrocardiographic and clinical outcomes of the patients survived out of
Materials & Methods: A descriptive study taking a series of cases suffered from lightning injury was
conducted in VIMSAR, Burla, between May 2020 to May-2021. Eight patients those who survived
from lightning injury and presented to the emergency department (ED) with abnormal ECG findings
were finally chosen as the study participants.
Results: Patients, those who survived from lightning injury were found to present with
electrocardiographic (ECG) pictures of myocardial ischemia or infarction with dreadful complications
like left ventricular failure, cardiac arrest and fatal arrhythmias like ventricular tachycardia.
Echocardiographic findings, biomarker values were found to be normal in some cases despite
characteristic electrocardiographic findings of ischemia or infarction. Angiogram findings were found
to be invariably normal in all cases. Abnormal ECG/Echo findings reverted back to normal
spontaneously or after intervention during hospitalisation. Conclusion: Mechanisms other than
coronary arthero-thrombosis i.e coronary vasospasm, autonomic stimulation, local thermal injury can
have important roles in the pathogenesis of electrocardiographic manifestations in patients survived
from lightning injury. Therefore these manifestations most often transient and can be discordant to
echocardiographic and laboratory findings like cardiac biomarkers. Patient can develop fatal
complications during this transient period. Hence timely appropriate interventions and close follow up
can save many lives.
Key words: Angiography, Biomarker, Electrocardiography, Echocardiography, Lightening injury