Abstract. Electrical injuries represent one of the contemporary problems in healthcare, often associated with high morbidity and mortality. Myocardial morphological damage can be caused by electrical injury and is found in 3.2% of victims. Evidence Collection. Literature sources were included in the study if they: 1) were published in Ukrainian, English, or Spanish; 2) reported cardiac arrhythmias associated with electrical injury; 3) provided information on the prevalence of organic myocardial cardiac lesions in electrical injury; 4) used an observational design (cohort or cross-sectional). Evidence Synthesis. A number of mechanisms of myocardial damage in electrical injury have been described. These include direct thermal damage, induction of coronary artery spasm, ischemia secondary to arrhythmic hypotension, acute hypertension due to chemoreceptor stimulation, catecholamine-mediated damage, and ischemia in the coronary artery basin as a component of generalized injury. The degree of external skin damage should not be used to determine the extent of internal injury, as the current flows through the body along various pathways depending on tissue resistance, contact surface area, and the volume of affected tissue. Patients with electrical injury are prone to developing myocardial infarction, considering the damage caused by the current at the level of the vascular intima and the occurrence of thrombosis. Myocardial infarction can be caused by spasm of the coronary arteries or their occlusion by blood clots. Acute tissue ischemia resulting from spasm of the smooth vascular muscles plays a significant role in the mechanism of these conditions. Electricity can lead to focal or diffuse heart damage and often causes necrosis involving the myocardium, nodal tissue, conduction pathways, and coronary arteries. A 24-hour observation period under continuous cardiac monitoring is currently recommended, even for asymptomatic patients without prior predisposing conditions. An elevated troponin level for diagnosing electrical cardiac injury mostly lacks fundamental clinical significance. Conclusions. Electrical damage to the cardiovascular system is accompanied by serious life-threatening complications, including the possibility of long-term ones. Cardiac monitoring in victims of electric shock should be performed for at least 24 hours.