Lightning and the heart.

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Abstract
Two patients sustained lightning-induced myocardial necrosis and had clinical evidence of myocardial injury. In the 1st case, clinically more severely affected, the ECG changes simulated acute inferior myocardial infarction while in the 2nd case only mild non-specific ST and T wave changes were seen. The presence of cardiac muscle creatine kinase isoenzyme confirmed that these non-specific changes reflected myocardial necrosis. Resting 201T myocardial imaging in the 1st case showed normal perfusion. In both cases there was complete clinical and ECG recovery.