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

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.