Reversible dilative cardiomyopathy after electrical injury
Despite the fact that dilative cardiomyopathy is not very common in electrical injuries but can be fatal, a prolonged echocardiography follow-up for patients with electrical injury could be recommended. Until now this case is the first child with severe burns after electrocution, who developed a reversible dilative cardiomyopathy.

Published in the Journal of Medical Case Reports, the authors report a case of a 12-year-old boy with a high voltage injury who developed a four-chamber dilative cardiomyopathy, which was diagnosed on the 13th week postburn. One year after the accident, echocardiography showed a normal function of his heart with 64% ejection fraction and normal cavities’ dimensions.

A 12-year-old boy suffered from an accidental electrocution with 15,000 volts as he was playing in a railroad car. The boy was intubated at the site of the accident and immediately admitted to our burn care unit with deep partial-thickness and full-thickness burns. He sustained a 70% total body surface area (TBSA) burn of the face, neck, spine, thorax, abdomen, both arms, and both legs. A source lesion was noted on his right shoulder, and a ground lesion was visible on his right thigh. Directly after the admission, escharotomy and tracheostomy took place.

The boy developed persisting hypotension, edema, and ascites after the 10th week postburn. The hypotension required dobutamine therapy. A chest X-ray revealed an increase of the cardiothoracic ratio from 0.50 (at the time of admission) to 0.63 (at this critical point). In order to clarify this persisting hypotension, a second echocardiography was performed.

The first echocardiography was performed 4 weeks after the accident proving the healthy initial condition of the heart of this young patient. A four-chamber DCM with biventricular dysfunction was diagnosed 13 weeks after the accident: left ventricular ejection fraction (LV-EF) 18%

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Dr. M●●●●h S●●m
Dr. M●●●●h S●●m Paediatrics
Nov 16, 2018Like