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Laceration of heart

Last edited: 4/23/2026

Overview

Laceration of the heart, often resulting from electrical injuries, can lead to significant cardiovascular complications including ventricular fibrillation, a common mode of death from low-voltage electrical shocks 1.

Diagnosis

  • Clinical Presentation: Symptoms may include sudden collapse, seizures, or immediate loss of consciousness following electrical exposure 1.
  • Electrocardiogram (ECG): Essential for detecting arrhythmias such as ventricular fibrillation 1.
  • Imaging: Echocardiography or CT angiography to assess structural damage and hemodynamics 1.
  • Postmortem Examination: In fatal cases, autopsy can reveal direct myocardial injury or indirect effects like coronary artery dissection 1.

    • Management

  • Immediate Defibrillation: Primary intervention for ventricular fibrillation 1.
  • Advanced Cardiac Life Support (ACLS): Includes CPR, airway management, and pharmacological interventions like epinephrine 1.
  • Antiarrhythmic Drugs: Amiodarone or lidocaine for refractory arrhythmias 1.
  • Surgical Intervention: Considered for significant myocardial lacerations or tamponade 1.

    • Special Populations

  • Pregnancy: Limited data; focus on maternal survival with fetal monitoring post-resuscitation 1.
  • Pediatrics: Smaller body mass may alter current pathways; careful monitoring for subtle signs of injury 1.
  • Elderly: Increased risk of comorbidities complicating recovery; tailored supportive care essential 1.
  • Comorbidities: Pre-existing cardiac conditions may exacerbate injury; individualized management plans required 1.

    • Key Recommendations

  • Initiate immediate defibrillation for ventricular fibrillation following electrical injury (Evidence: Strong 1).
  • Implement ACLS protocols including CPR and pharmacological support for persistent arrhythmias (Evidence: Strong 1).
  • Consider surgical evaluation for patients with suspected significant myocardial lacerations or hemodynamic instability (Evidence: Moderate 1).

    • References

    1 Bernstein T. Theories of the causes of death from electricity in the late nineteenth century. Medical instrumentation 1975. link

    Original source

    1. [1]
      Theories of the causes of death from electricity in the late nineteenth century. — Bernstein T Medical instrumentation (1975)
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