A person who has been struck by lightning may or may not show changes in the electrocardiogram. If changes are present then they may or may not be significant.


Changes that may be encountered:

(1) nonspecific changes in ST segment and T wave

(2) ischemic-type changes secondary to damage to myocytes

(3) acute myocardial infarction

(4) cardiac arrhythmias, including sinus tachycardia, ventricular tachycardia, atrial fibrillation and cardiac arrest

(5) a conduction defect

(6) changes secondary to autonomic dysfunction


Ventricular arrhythmias may show a delayed onset. If the path taken by the electric current crossed the thorax, then the patient should have the ECG monitored for at least 24 hours after the injury.


According to Carleton, a patient who has had significant cardiac changes following a lightning strike should be followed for at least 12 months. In addition, the patient should avoid elective surgery for the first 6 months after the incident.


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