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Cardiogenic shock following blunt chest trauma.

Rodríguez-González F, Martínez-Quintana E - J Emerg Trauma Shock (2010)

Bottom Line: Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest.Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia.We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

View Article: PubMed Central - PubMed

Affiliation: Intensive Medicine Service, Cardiology Service, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain.

ABSTRACT
Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

No MeSH data available.


Related in: MedlinePlus

Electrocardiogram on admission depicting 1 mm ST segment elevation in lateral leads with associated right bundle branch block and ventricular beats in couplet
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Figure 0001: Electrocardiogram on admission depicting 1 mm ST segment elevation in lateral leads with associated right bundle branch block and ventricular beats in couplet

Mentions: A 47-year-old man was referred to our hospital after a fall impact from a height of 6 m. On admission, the patient was awake and reported abdominal and thoracic pain. During clinical evaluation, he presented a cardiac arrest due to ventricular fibrillation that required four cardiac defibrillations, intubation, and mechanical ventilation. The patient recovered sinus rhythm but again presented hemodynamic instability with bilateral lung hypoventilation at auscultation. Tension pneumothorax was suspected and thoracic tubes were inserted into both sides of the chest. Episodes of ventricular tachycardia were treated with amiodarone and a complete atrioventricular block with a transitory pacemaker. A radiograph of the chest showed inferior left and right costal fractures, and free pelvic and abdominal liquid was observed by abdominal ultrasound. An exploratory laparotomy was conducted, proceeding to splenectomy due to spleen rupture. The electrocardiogram showed a 1-mm ST segment elevation in lateral leads with associated right bundle branch block [Figure 1].


Cardiogenic shock following blunt chest trauma.

Rodríguez-González F, Martínez-Quintana E - J Emerg Trauma Shock (2010)

Electrocardiogram on admission depicting 1 mm ST segment elevation in lateral leads with associated right bundle branch block and ventricular beats in couplet
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966575&req=5

Figure 0001: Electrocardiogram on admission depicting 1 mm ST segment elevation in lateral leads with associated right bundle branch block and ventricular beats in couplet
Mentions: A 47-year-old man was referred to our hospital after a fall impact from a height of 6 m. On admission, the patient was awake and reported abdominal and thoracic pain. During clinical evaluation, he presented a cardiac arrest due to ventricular fibrillation that required four cardiac defibrillations, intubation, and mechanical ventilation. The patient recovered sinus rhythm but again presented hemodynamic instability with bilateral lung hypoventilation at auscultation. Tension pneumothorax was suspected and thoracic tubes were inserted into both sides of the chest. Episodes of ventricular tachycardia were treated with amiodarone and a complete atrioventricular block with a transitory pacemaker. A radiograph of the chest showed inferior left and right costal fractures, and free pelvic and abdominal liquid was observed by abdominal ultrasound. An exploratory laparotomy was conducted, proceeding to splenectomy due to spleen rupture. The electrocardiogram showed a 1-mm ST segment elevation in lateral leads with associated right bundle branch block [Figure 1].

Bottom Line: Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest.Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia.We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

View Article: PubMed Central - PubMed

Affiliation: Intensive Medicine Service, Cardiology Service, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Spain.

ABSTRACT
Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

No MeSH data available.


Related in: MedlinePlus