What cardiac complications are associated with lightning strike injuries?

• A. Only respiratory failure
• B. Arrhythmias, myocardial injury, and conduction abnormalities with possible immediate or delayed cardiac arrest
• C. No cardiac issues
• D. Peripheral nerve damage

Answer: (B)

Lightning strikes can deliver a massive, short-lived current that travels through the chest, directly affecting the heart’s electrical system and causing injury to the myocardium. This can lead to a range of cardiac issues: rhythm disturbances (arrhythmias) such as ventricular fibrillation or other tachyarrhythmias, conduction abnormalities like heart blocks, and direct myocardial injury that impairs contractile function. Together, these problems can trigger immediate cardiac arrest or can lead to arrest after a delay as the heart’s tissue and conduction pathways are damaged and then destabilize. That combination—arrhythmias, myocardial injury, and conduction abnormalities with potential immediate or delayed cardiac arrest—is the best description of cardiac complications from lightning. Other options miss the full picture: respiratory failure alone doesn’t capture the cardiac risks, and while nerve damage can occur from lightning, it’s not the primary cardiac issue described here.