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Accidental electrical injuries are quite common, but suicide attempts by electrocution are rare and are scarcely mentioned in the medical literature. The author describes the case of a male nurse who unsuccessfully attempted suicide by applying a 5,165-volt cardiac defibrillator to his head. The author also reviews the electrophysiology involved and discusses the psychodynamics that prompted this action.
Four lethal and one nonlethal electrocutions from street lighting equipment are described. These cases have in common old installations, metal light poles, wet environment, 480-V power sources, and intact fuses. Identification of causative factors may permit future accommodation in design to reduce risk.
From 1979 to 1982, in the United States, at least 95 persons were electrocuted in bathtubs; 66% of the deaths occurred during the winter and spring. Children younger than 5 years had the greatest mortality rate, and hair dryers were responsible for 60% of the deaths. Until electric appliances used in bathrooms are made safer, the appliances should be disconnected when not in use, not used in wet bathtubs, and kept away from children.
Two cases of death from electrocution during auto-erotic procedures are presented. These are accidental deaths and need to be distinguished from suicidal deaths.
We report on a case of non-fatal myocardial infarction (MI) after electrocution. The diagnosis was made on the basis of electrocardiographic and enzymatic changes and was supported by the results of two-dimensional echocardiogram and radio-nuclide scans, showing segmental hypoperfusion and wall motion abnormalities. The patient was followed for over 8 years, evaluating the evolution of cardiac damage with the above tests. MI associated with electrical injury is very likely overestimated, owing to the low specificity of classical diagnostic criteria, such as ECG changes and CK-MB elevation, and the short monitoring of survivors. We suggest that non-invasive functional methods, exploring myocardial perfusion and ventricular kinesis, and a longer follow-up can reliably assess the prevalence of this complication.
We present a case of accidental electrocution in a 62-years-old male. After the accident he referred a non-specific thoracic pain that disappeared in a week, remaining asymptomatic since then. On the other hand, he shows a permanent electrocardiographic pattern of anterolateral subepicardial ischaemia. Myocardial function revealed by echocardiography and pertechnectate gammagraphy, showed an early primary damage, with a posterior slow tendency to recovery. Exercise treadmill test and Tallium-Dipyridamole test were normal, so an ischaemic background could be rejected in this case. No other diseases were presented, so the changes observed could be exclusively connected with the electrical accident.
Electrical injury can affect many organ systems, it seems that the damage results from the conversion of electrical energy into heat. Electrical injuries to the heart are far less frequent and thus, less known. Additionally, it is very difficult to interpret electrocardiographic and enzymatic changes, which are, in other situations, diagnostic of a myocardial infarction. We report two cases of young men without coronary risk factors. They present a rise in enzyme levels and electrocardiographic changes suggestive of acute myocardial infarction after alternating current electrocution. The difficulties in evaluating the myocardial damage in these situations are also discussed. We recommend ECG monitoring and long-term cardiac evaluation of these patients.
A case of seldom electrocution by using a timer is presented being carried out from a 35 year old woman, who didn't have any professional background. As the fundamental histological result and classical vital reaction a bone marrow embolism was found. Circumstances, results and line of argumentation are presented in detail and discussed.
We present the case of a young man who suffered severe anteroapical myocardial necrosis caused by electrocution. In addition to the enzymatic and electrocardiographic changes suggesting necrosis, a clear positive segmental image on 99mTc-pyrophosphate scintigraphy and a defect on a 201Tl SPECT scan at rest were also found. Although these tests were indicative of extensive anteroapical transmural myocardial necrosis, the echocardiographic study only revealed mild anteroapical hypokinesia.
A 28-year-old male was found dead on a bed in a hotel. He had two electric wires, the ends of which were fastened to each coin (50 and 100 yen); the coins were attached to a left hypochondrial region and a left side of the chest. The other ends of the wires were connected to a time switch, which had been connected to a plug top (100 V, 60 Hz alternating current). An empty box of a commercially available hypnotic (bromvalerylurea), a suicide note and a manual book for suicide were found at the spot. As autopsy findings, both burns on the left hypochondrial region and on the left side of the chest were carbonized at their central parts and erythemas were also noted around them. Histological findings were consistent with electric marks and the burns showed vital reactions. Copper stain was slightly positive; iron stain was negative. Bromvalerylurea concentrations in blood, urine, brain, liver and kidney samples were 14.5, 37.7, 5.8, 5.2 and 6.2 micrograms/ml or g, respectively. The blood level showed that he had been moderately intoxicated by the drug, but not fatal. The cause of death was thus judged to be suicidal electrocution. It seems that suicide was influenced by a "Manual Book of Suicide", which was found in his bag.
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A young woman was found dead in a bath-tub with her facial orifices under water and current burn marks at the right big toe and at the neck near the hairline. Initial police investigations assumed an accidental electric shock due to a radio falling into the water. The forensic autopsy was followed by extensive histology and immunohistochemistry of the internal organs and skin marks. Intensive vital reactions of a near-drowning were detected that suggested a survival period of at least 20 min. Furthermore, an energy dispersive x-ray spectroscopy analysis on the current burn marks and on possible current applicators was performed, as well as reconstruction experiments with a cadaver of a pig that had been slaughtered shortly before. The results of all investigations revealed a two-step procedure with a primary near-drowning and a final current application with consecutive cardiac arrest.