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Circulation. Cardiovascular Imaging Mar 2015
Topics: Bundle-Branch Block; Child; Contusions; Coronary Angiography; Edema, Cardiac; Electrocardiography; Heart Injuries; Humans; Magnetic Resonance Imaging; Male; Multimodal Imaging; Predictive Value of Tests; Wounds, Nonpenetrating
PubMed: 25681418
DOI: 10.1161/CIRCIMAGING.114.002857 -
The American Journal of Cardiology Oct 2021Non-penetrating chest blows can occasionally trigger fatal ventricular tachyarrhythmias and sudden death (commotio cordis). Such events were initially reported in...
Non-penetrating chest blows can occasionally trigger fatal ventricular tachyarrhythmias and sudden death (commotio cordis). Such events were initially reported in association with sporting activities and projectiles such as baseball/lacrosse balls. However, similar potentially fatal chest blows, seemingly incapable of causing death, can occur during a variety of other circumstances such as when delivered during a fight (by a fist) such as in the accompanying paper. Notably, commotio cordis events can be reversed by resuscitation and defibrillation.
Topics: Baseball; Commotio Cordis; Death, Sudden, Cardiac; Humans; Tachycardia, Ventricular; Ventricular Fibrillation
PubMed: 34304863
DOI: 10.1016/j.amjcard.2021.05.053 -
Journal of Veterinary Emergency and... 2013To describe the clinical findings and management of myocardial injury secondary to blunt thoracic trauma and rib fracture in an adult horse.
OBJECTIVE
To describe the clinical findings and management of myocardial injury secondary to blunt thoracic trauma and rib fracture in an adult horse.
CASE SUMMARY
A 6-year-old Warmblood gelding presented for treatment of blunt thoracic trauma. Sonographic examination of the thorax revealed a complete, mildly comminuted fracture of the left 5th rib with a fragment overlying the left atrium and coronary artery, hemothorax, and subjective left ventricular dyskinesis. Evidence of myocardial injury included atrial fibrillation, ventricular ectopy, and increased plasma cardiac troponin I concentration. The rib fracture was repaired under general anesthesia using a wire and plate technique. The atrial fibrillation converted to normal sinus rhythm coincidentally with intraoperative local infusion of mepivicaine in administration of intercostal perineural analgesia. Continuous, resting, and exercising electrocardiograms, serial cardiac troponin I concentrations and echocardiograms were used to monitor the myocardial injury. The horse was discharged after 5 days of hospitalization. Reexaminations 3 and 15 months after the initial trauma showed healing of the fracture and no evidence of myocardial sequelae.
NEW OR UNIQUE INFORMATION PROVIDED
To our knowledge, this is the first documentation of the diagnosis and monitoring of myocardial injury secondary to blunt thoracic trauma, as well as surgical repair of a rib fracture in an adult horse. Rib fractures and myocardial trauma can be successfully managed in adult horses and myocardial injury should be considered in cases of thoracic trauma.
Topics: Animals; Arrhythmias, Cardiac; Contusions; Heart Injuries; Horse Diseases; Horses; Rib Fractures
PubMed: 24028390
DOI: 10.1111/vec.12096 -
Surgery Aug 1989To evaluate the significance of myocardial contusion, we evaluated 243 stable patients hospitalized for blunt chest trauma between 1982 and 1986. The groups were...
To evaluate the significance of myocardial contusion, we evaluated 243 stable patients hospitalized for blunt chest trauma between 1982 and 1986. The groups were identified according to results of radionuclide angiography, mean injury severity score (ISS), and outcome. Group I (n = 71; mean ISS = 12.7) patients were those without myocardial contusion by radionuclide angiography. Two patients with cardiac complications were in this group. The patients with myocardial contusion were divided into two groups. Group II (n = 69; ISS = 19.5) patients had myocardial contusion as an isolated injury, and group III (n = 103; ISS = 30.9) patients had myocardial contusion and injury to at least one other organ system. Three patients from group II had cardiac complications. Eleven patients from group III had cardiac complications. There were no significant differences between the cardiac complication rate in the three groups, and each complication was present when the patient arrived in the emergency department. The predicted mortality rate based on ISS was 10% to 20% for patients with myocardial contusion, whereas the observed mortality rate for the groups (II and III) overall was 0.58%. We conclude that in the stable trauma patient myocardial contusion (1) does not by itself increase the risk of complication, (2) does not necessitate intensive care unit monitoring, (3) should be devalued when computing ISS scores, (4) may account for lengthy and often unnecessary hospitalization, and (5) in patients at risk for complications may be identified by ECG abnormalities on arrival to the emergency department.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Contusions; Electrocardiography; Female; Heart Injuries; Hemodynamics; Humans; Middle Aged; Radionuclide Angiography; Retrospective Studies; Wounds, Nonpenetrating
PubMed: 2763029
DOI: No ID Found -
Archives of Surgery (Chicago, Ill. :... Apr 1990
Topics: Contusions; Heart Injuries; Humans
PubMed: 2322124
DOI: 10.1001/archsurg.1990.01410160139027 -
Radiologic Clinics of North America Jan 2019Cardiac injury can occur in the setting of blunt and penetrating trauma resulting in significantly adverse clinical outcomes. Although the clinical presentation is... (Review)
Review
Cardiac injury can occur in the setting of blunt and penetrating trauma resulting in significantly adverse clinical outcomes. Although the clinical presentation is variable and computed tomographic imaging is rarely performed to specifically evaluate for cardiac injury, the ability to recognize the findings of cardiac injury on computed tomographic examinations performed for thoracic trauma is essential to avoid misdiagnosis and direct potentially lifesaving interventions. This article reviews the direct and indirect computed tomographic findings of cardiac injury.
Topics: Contrast Media; Diagnosis, Differential; Heart Injuries; Humans; Tomography, X-Ray Computed
PubMed: 30454813
DOI: 10.1016/j.rcl.2018.08.009 -
Angiology Nov 2016Cardiac trauma is a leading cause of death in the United States and occurs mostly due to motor vehicle accidents. Blunt cardiac trauma and penetrating chest injuries are... (Review)
Review
Cardiac trauma is a leading cause of death in the United States and occurs mostly due to motor vehicle accidents. Blunt cardiac trauma and penetrating chest injuries are most common, and both can lead to aortic injuries. Timely diagnosis and early management are the key to improve mortality. Cardiac computed tomography and cardiac ultrasound are the 2 most important diagnostic modalities. Mortality related to cardiac trauma remains high despite improvement in diagnosis and management.
Topics: Accidents, Traffic; Adolescent; Adult; Aorta, Thoracic; Aortography; Athletic Injuries; Blast Injuries; Cause of Death; Child; Child, Preschool; Echocardiography, Doppler, Color; Echocardiography, Transesophageal; Electrocardiography; Female; Heart Injuries; Humans; Infant; Male; Middle Aged; Myocardial Contusions; Pericardium; Risk Factors; Sensitivity and Specificity; Survival Rate; Tomography, X-Ray Computed; Wounds, Penetrating; Young Adult
PubMed: 26802100
DOI: 10.1177/0003319715627954 -
Heart (British Cardiac Society) May 2003Cardiac contusion is usually caused by blunt chest trauma and therefore is frequently suspected in patients involved in car or motorcycle accidents. The diagnosis of a... (Review)
Review
Cardiac contusion is usually caused by blunt chest trauma and therefore is frequently suspected in patients involved in car or motorcycle accidents. The diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardiac contusion can cause life threatening arrhythmias and cardiac failure. Many diagnostic methods, such as ECG, biochemical cardiac markers, transthoracic and transoesophageal echocardiography, and radionuclide imaging studies, have been investigated to determine their use in predicting such complications. Recently, cardiac troponin I and T were found to be highly sensitive for myocardial injury. Troponin I and T have also proved to be useful in the stratification of patients at risk for complications. Nevertheless, diagnosis of a cardiac contusion and identification of patients at risk remain a challenge. In this review the current diagnostic tests will be discussed. Also, based on these diagnostic tests, a screening strategy containing data from the latest studies is presented, with the intention of detecting patients at risk.
Topics: Algorithms; Biomarkers; Contusions; Echocardiography; Electrocardiography; Heart Injuries; Humans; Prognosis; Radionuclide Imaging; Risk Factors; Thoracic Injuries; Wounds, Nonpenetrating
PubMed: 12695446
DOI: 10.1136/heart.89.5.485 -
Journal of Cardiothoracic Surgery Feb 2023Blunt cardiac injury (BCI) encompasses a spectrum of pathologies ranging from clinically silent, transient arrhythmias to deadly cardiac wall rupture. Of diagnosed BCIs,... (Review)
Review
Blunt cardiac injury (BCI) encompasses a spectrum of pathologies ranging from clinically silent, transient arrhythmias to deadly cardiac wall rupture. Of diagnosed BCIs, cardiac contusion is most common. Suggestive symptoms may be unrelated to BCI, while some injuries may be clinically asymptomatic. Cardiac rupture is the most devastating complication of BCI. Most patients who sustain rupture of a heart chamber do not reach the emergency department alive. The incidence of BCI following blunt thoracic trauma remains variable and no gold standard exists to either diagnose cardiac injury or provide management. Diagnostic tests should be limited to identifying those patients who are at risk of developing cardiac complications as a result of cardiac in jury. Therapeutic interventions should be directed to treat the complications of cardiac injury. Prompt, appropriate and well-orchestrated surgical treatment is invaluable in the management of the unstable patients.
Topics: Humans; Heart Injuries; Heart; Myocardial Contusions; Heart Rupture; Wounds, Nonpenetrating; Rupture; Thoracic Injuries
PubMed: 36765392
DOI: 10.1186/s13019-023-02146-z -
Acta Clinica Belgica 1985
Topics: Adult; Aged; Contusions; Creatine Kinase; Diphosphates; Echocardiography; Electrocardiography; Female; Heart Injuries; Humans; Isoenzymes; Male; Middle Aged; Technetium; Technetium Tc 99m Pyrophosphate; Thoracic Injuries
PubMed: 3006411
DOI: 10.1080/22953337.1985.11719107