2025 Scholars' Research Symposium Abstract: Lightning Associated with More Visits to the Emergency Department for Chest Pain.

Introduction: Chest pain is a common reason for visits to the emergency department. This project explored weather related events, particularly thunder events, and their association with chest pain and myocardial infarction. Changing weather patterns have previously been linked to cardiovascular complaints in the emergency department. Additionally, researchers have been able to link chronic noise pollution, like traffic noise, to a significant increase in cardiovascular disease. However, little is known about the relationship between a single loud noise, such as thunder after a lightning strike, and myocardial infarction.

Methods: Location and time of lightning events in a 100-mile radius of Avera McKennan Hospital in Sioux Falls, SD from June 1, 2021 through July 31, 2021 was obtained from Global measurement instruments company Vaisala. Data for thunder was not available. The McKennan Emergency Department electronic medical record was queried for chief complaints of chest pain and dermatologic complaints (control group) during the same timeframe using ICD codes. Patients presenting to the ED for chest pain were further evaluated to determine if they were diagnosed with a myocardial infarction. Date of patient presentation to the ED was then cross-referenced to the Vaisala lightning data to determine if lightning, and therefore thunder, occurred on the date of presentation. The number of chest pain complaints on days with lightning was compared to number of dermatologic complaints to determine statistical significance using a chi-squared test.

Results: From June 1, 2021, to July 31, 2021, 188 of 309 patients presented to Avera McKennan Emergency Department with a chest pain complaint on a day with lightning. A total of 5 patients were diagnosed with myocardial infarction. Of the patients diagnosed with a myocardial infarction, 4 of the 5 patients presented on a day with recorded lightning. Lightning was recorded on 39 of the 61 days of our timeframe. To evaluate differing lead times for lightning events, p-values for various times post-lightning strike were analyzed. A p-value less than or equal to 0.5 was considered significant. This study showed a p-value of 0.034 at 0.5 hours after lightning strike. At 2.5, 3, 4, 4.5, 5, and 5.5 hours after a lightning strike occurred the p-values were 0.047, 0.033, 0.029, 0.018, 0.019, and 0.039 respectively.

Conclusions: This study showed a significant increase in patients presenting to the emergency department with chest pain complaints 0.5 hours after lightning strike and between 2.5-5.5 hours after lightning strike. Limitations to this study include distance from lightning strike and intensity of lightning strike not being considered. Additionally, there was a small sample size for the group of patients diagnosed with an MI (n=5). These are areas that could be looked at further to better understand the relationship between a single loud event and chest pain. There was a trend toward significant association between lightning strikes and myocardial infarction, but due to the small sample size, no statistically significant correlation was found.