Constitutional predisposition to vasovagal syncope: an additional risk factor in patients exposed to electrical injuries?

An hour after a 220 V electric shock a patient who was susceptible to mild vasovagal symptoms in response to emotional stress had a severe episode of cardiac arrest in response to insertion of a cannula. No myocardial damage or conduction abnormalities were detected by serial 12 lead electrocardiograms. Patients with a history of vasovagal reactions may be at high risk of developing lethal sinus node or conduction disturbances after electrical injuries. Psychological stresses should be avoided in the management of such patients.