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Lightning and the heart.

Two patients sustained lightning-induced myocardial necrosis and had clinical evidence of myocardial injury. In the first case, clinically more severely affected, the electrocardiographic changes simulated acute inferior myocardial infarction while in the second case only mild non-specific ST and T wave changes were seen. The presence of cardiac muscle creatine kinase isoehzyme confirmed that these non-specific changes also reflected myocardial necrosis. Resting thallium-201 myocardial imaging in the first case showed normal perfusion. In both cases there was complete clinical and electrocardiographic recovery.