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California Medicine Sep 1967
Topics: Blood Chemical Analysis; Child; Contusions; Electrocardiography; Heart Injuries; Humans; Male
PubMed: 6075466
DOI: No ID Found -
The Journal of Trauma Apr 1988Myocardial contusion is becoming more frequently recognized as a concomitant of blunt chest and abdominal trauma. Thromboembolism is an infrequent, but serious,... (Review)
Review
Myocardial contusion is becoming more frequently recognized as a concomitant of blunt chest and abdominal trauma. Thromboembolism is an infrequent, but serious, complication of myocardial contusion and management is controversial. We report a case and review the literature of thromboembolism complicating blunt heart injury, and suggest a protocol to prevent this complication.
Topics: Adolescent; Adult; Contusions; Female; Heart Injuries; Humans; Male; Middle Aged; Pulmonary Embolism; Thrombophlebitis
PubMed: 3280820
DOI: 10.1097/00005373-198804000-00022 -
Emergency Medicine Journal : EMJ Mar 2005A short cut review was carried out to establish the utility of troponin levels in diagnosing myocardial contusion following blunt chest trauma. Using the reported... (Review)
Review
A short cut review was carried out to establish the utility of troponin levels in diagnosing myocardial contusion following blunt chest trauma. Using the reported search, 75 papers were found, of which six presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
Topics: Biomarkers; Contusions; Evidence-Based Medicine; Heart Injuries; Humans; Troponin; Wounds, Nonpenetrating
PubMed: 15735270
DOI: 10.1136/emj.2004.022822 -
The American Surgeon Aug 1982During a consecutive period of 26 months, 42 patients with blunt chest trauma were diagnosed as having a myocardial contusion on the basis of an abnormal...
During a consecutive period of 26 months, 42 patients with blunt chest trauma were diagnosed as having a myocardial contusion on the basis of an abnormal electrocardiogram (ECG) in 36 patients, elevated creatine phosphokinase (CPK) in 39 patients, and positive CPK-Muscle Brain (CPK-MB) isoenzyme in 33 patients. Using these screening modalities, the incidence of myocardial contusion in patients with blunt chest trauma increased from 7 per cent when viewed retrospectively to 17 per cent when viewed prospectively. Eight patients had cardiac index determinations only; of these, three were less than 2.9 1/min/M2. An additional 21 patients underwent a standard fluid challenge of 500 cc of 5 per cent plasmanate infused over 30 minutes allowing construction of a Starling Curve. Five patterns of ventricular function curves were observed. Six patients had biventricular dysfunction, six patients had isolated right ventricular dysfunction, three patients had isolated left ventricular dysfunction, three patients had an "unslope-peak-downslope" pattern, and three patients had normal ventricular function studies. Multiple gated acquisition (MUGA) scans were abnormal in ten patients and normal in 12 patients. Major morbidity and mortality due to myocardial contusion occurred in 17 per cent of the (7/42) patients; of these, three had biventricular dysfunction, one had left ventricular dysfunction, and two had a low cardiac index. This experience suggests that screening tests are sensitive in detecting myocardial contusion in blunt chest trauma, but are not predictive of major morbidity or mortality. Only direct hemodynamic measurement with construction of a Starling Curve was useful in determining the severity of the myocardial injury and identifying those patients at greatest risk.
Topics: Adolescent; Adult; Aged; Child; Contusions; Creatine Kinase; Electrocardiography; Female; Heart Function Tests; Heart Injuries; Hemodynamics; Humans; Isoenzymes; Male; Middle Aged; Radionuclide Imaging; Thoracic Injuries
PubMed: 7114607
DOI: No ID Found -
The American Journal of Cardiology Nov 2019
Topics: Commotio Cordis; Death, Sudden; United Kingdom; Humans; Sports
PubMed: 31537298
DOI: 10.1016/j.amjcard.2019.08.006 -
Cell Biochemistry and Biophysics Jan 2012We sought to investigate the role of two-dimensional stress echocardiography in the early assessment of myocardial contusion. For this purpose, 12 dogs, weighing 11.36...
We sought to investigate the role of two-dimensional stress echocardiography in the early assessment of myocardial contusion. For this purpose, 12 dogs, weighing 11.36 ± 1.50 kg, were selected and the myocardial contusion was experimentally induced. Two-dimensional dobutamine stress echocardiography (DSE) was used to detect abnormal myocardial motions segments at time phases of baseline and 0.5, 2, 4, and 8 h post-wounding. Finally, the above results were compared with pathological findings. The data show that after the dogs were induced to have severe myocardial contusion, 122 segments were found with abnormal myocardial wall motions at 0.5 h post-wounding, 133 segments at 2 h post-wounding, and 142 segments, each, at 4 h and 8 h post-wounding. The wall motion score (WMS) and wall motion score index (WMSI) increased (P < 0.001) as compared with the pre-impaction values. Considering the left ventricular axis view as the standard section, in the 60 segments examined by echocardiography, 54 segments were found to have wall motion abnormalities. Comparing with the results of pathological TTC staining, the sensitivity and specificity were found to be 100 and 66.6%, respectively. It was, therefore, concluded that two-dimensional DSE was a valuable technique in the early diagnosis of myocardial contusion due to its better sensitivity and specificity.
Topics: Animals; Cardiotonic Agents; Coronary Artery Disease; Dobutamine; Dogs; Echocardiography, Stress; Hemodynamics; Sensitivity and Specificity; Ventricular Function, Left
PubMed: 21910029
DOI: 10.1007/s12013-011-9278-1 -
Sports Medicine (Auckland, N.Z.) Aug 2023Since the nationally televised cardiac arrest of American National Football League player Damar Hamlin in January 2023, commotio cordis has come to the forefront of... (Review)
Review
Since the nationally televised cardiac arrest of American National Football League player Damar Hamlin in January 2023, commotio cordis has come to the forefront of public attention. Commotio cordis is defined as sudden cardiac arrest due to direct trauma to the precordium resulting in ventricular fibrillation or ventricular tachycardia. While the precise incidence of commotio cordis is not known due to a lack of standardized, mandated reporting, it is the third most common cause of sudden cardiac death in young athletes, with more than 75% of cases occurring during organized and recreational sporting events. Given that survival is closely tied to how quickly victims receive cardiopulmonary resuscitation and defibrillation, it is crucial to raise awareness of commotio cordis so that athletic trainers, coaches, team physicians, and emergency medical personnel can rapidly diagnose and treat this often-fatal condition. Broader distribution of automated external defibrillators in sporting facilities as well as increased presence of medical personnel during sporting events would also likely lead to higher survival rates.
Topics: Humans; Commotio Cordis; Cardiopulmonary Resuscitation; Death, Sudden, Cardiac; Arrhythmias, Cardiac; Football
PubMed: 37382827
DOI: 10.1007/s40279-023-01873-6 -
Archives of Surgery (Chicago, Ill. :... Jul 1989The clinical significance of various diagnostic tests and the length of monitoring required for myocardial contusion were evaluated in 172 patients. Cardiac isoenzyme...
The clinical significance of various diagnostic tests and the length of monitoring required for myocardial contusion were evaluated in 172 patients. Cardiac isoenzyme levels, electrocardiograms, and echocardiograms were evaluated. Twenty-eight patients had a documented myocardial contusion based on at least one positive diagnostic study. The majority of positive studies were detected on admission and all positive tests were present within 24 hours. No patients developed positive diagnostic studies after 24 hours and, likewise, no clinical deterioration occurred late or in patients with a negative screening examination. The electrocardiogram and the clinical course were the therapeutic intervention. Cardiac isoenzyme levels had negligible significance on outcome, and the two-dimensional echocardiogram was not particularly valuable as a screening technique, If no abnormality is detected within 24 hours post injury, further investigation or monitoring does not appear warranted.
Topics: Adolescent; Adult; Aged; Arrhythmias, Cardiac; Contusions; Creatine Kinase; Echocardiography; Electrocardiography; Female; Heart Injuries; Humans; Isoenzymes; Male; Middle Aged; Monitoring, Physiologic; Prospective Studies; Thoracic Injuries; Wounds, Nonpenetrating
PubMed: 2742480
DOI: 10.1001/archsurg.1989.01410070059012 -
Canadian Journal of Surgery. Journal... Jan 1983Because myocardial dysfunction may result from severe trauma, the author assessed, prospectively, left and right ventricular function in 25 patients who had sustained...
Because myocardial dysfunction may result from severe trauma, the author assessed, prospectively, left and right ventricular function in 25 patients who had sustained severe trauma, including blunt chest injury, by electrocardiographically gated blood pool radionuclide angiography. Focal abnormalities of ventricular wall motion were defined in 17 patients: right ventricular in 12, left ventricular in 2 and biventricular in 3. Traumatic tricuspid insufficiency demonstrated in two patients was subsequently verified by contrast angiography. Other means of detecting myocardial contusion (enzymatic, electrocardiographic and scintigraphic) proved to be insensitive when compared with radionuclide angiography. Two of the five deaths were attributed to refractory arrhythmias. Surgical or autopsy evidence of traumatic myocardial injury was obtained in five instances when radionuclide angiography indicated contusion. Of the 13 patients available for follow-up, 11 showed complete or partial resolution of the ventricular wall abnormality and in 2 there was no change. Comprehensive cardiopulmonary monitoring revealed an inverse relation between the right ventricular ejection fraction and pulmonary vascular resistance as well as between the pulmonary vascular resistance and left ventricular ejection fraction and left ventricular end-diastolic volume. Further, as the right ventricular end-diastolic volume was increased in trauma, left ventricular function and compliance were reduced. In blunt chest trauma, right ventricular contusion occurs more frequently than has been recognized previously and positive radionuclide angiography constitutes prima facie evidence of direct myocardial injury. Moreover, left ventricular function remains preload-dependent, but may be depressed by elevated pulmonary vascular resistance, impeding the blood flow from the right to left ventricle, and decreased left ventricular compliance, or both.
Topics: Accidents, Traffic; Cineangiography; Contusions; Diphosphates; Electrocardiography; Heart Injuries; Hemodynamics; Humans; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate; Wounds, Nonpenetrating
PubMed: 6295585
DOI: No ID Found -
British Heart Journal Apr 1941
PubMed: 18609873
DOI: 10.1136/hrt.3.2.127