Blunt Cardiac Injury

Bock, Jeremy S.; Benitez, R. Michael

doi:10.1016/j.ccl.2012.07.001

Cited by 37 publications

(72 citation statements)

References 58 publications

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“…Furthermore, although TTE has the advantage of being point of care and not requiring patient transportation, Bock and colleagues found that TTE was not as sensitive at predicting major adverse cardiac events as cardiac MRI (CMR), as well as described poor correlation between TTE and CMR. 16 …”

Section: Discussionmentioning

confidence: 99%

“…Specifically, in the Bock study, it was found that among 65 patients who were haemodynamically stable with normal screening ECG on arrival to the ED, there was not a single malignant arrhythmia or case of pump failure observed. 16 Among the patients who developed myocardial contusion or segmental wall motion abnormalities, the majority of arrhythmia or hypokinesia resolved within 24 hours. Therefore, cardiac sequelae 1 year after cardiac contusion in haemodynamically stable patients are rare.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, cardiac sequelae 1 year after cardiac contusion in haemodynamically stable patients are rare. 16 In patients with a negative troponin I and minimal electrical disturbance prognosis is good. However, in more pronounced electrical disturbance, such as what our patient had, this indicates more severe underlying injury.…”

Section: Discussionmentioning

confidence: 99%

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Paediatric chest wall trauma causing delayed presentation of ventricular arrhythmia

Tegethoff¹,

Raney

Mendelson

et al. 2017

BMJ Case Reports

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This report describes a paediatric patient presenting with haemodynamically stable non-sustained ventricular tachycardia 1 day after minor blunt chest trauma. Initial laboratory studies, chest X-ray and echocardiography were normal; however, cardiac MRI revealed precordial haematoma, myocardial contusion and small pericardial effusion. Throughout her hospital course, she remained asymptomatic aside from frequent couplets and triplets of premature ventricular contractions. Ectopy was controlled with oral verapamil. This case highlights how significant cardiac injury may be missed with standard diagnostic algorithms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Paediatric chest wall trauma causing delayed presentation of ventricular arrhythmia

Tegethoff¹,

Raney

Mendelson

et al. 2017

BMJ Case Reports

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“…Motor vehicle accidents are the most common cause, but other accidents, including falls from heights, sports accidents, bomb injuries, and animal kicks, can cause cardiac trauma ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Tricuspid and Mitral Valve Regurgitation with Bi-fascicular Block Following a Horse Kick

et al. 2018

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A 40-year-old man was transferred to our hospital following an isolated horse kick injury to the anterior chest wall. The case showed bi-fascicular block, severe tricuspid valve regurgitation due to ruptured chordae tendineae of the anterior leaflet, moderate mitral valve regurgitation due to prolapse of mitral anterior leaflet, and hypokinetic motion of the inferior septal wall. Both tricuspid and mitral insufficiency were completely repaired by a surgical operation. Fortunately, these injuries were not fatal in this case, but the comprehensive assessment of cardiac damage and careful observation are important for managing patients with cardiac injury.

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“…Cardiac contusion, coronary dissection, coronary artery intramural hematoma, epicardial hematoma, and commotio cordis are some disease entities that occur secondary to blunt trauma. 1 Myocardial infarction after blunt trauma can be secondary to dissection, intramural hematoma, or extrinsic compression from hematoma. Coronary intramural hematoma is a rare complication after blunt trauma, other causes being iatrogenic during percutaneous coronary intervention, spontaneous and retrograde propagation of aortic dissection.…”

mentioning

confidence: 99%

Myocardial Injury After Blunt Trauma

et al. 2015

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A 43-year-old healthy Amish man presented to the emergency department with a history of blunt trauma to the chest following a horse kick. The blunt trauma happened 6 hours before presentation. He also reported loss of consciousness for a brief period of 5 minutes. After regaining consciousness, he experienced constant dull ache in his chest that radiated to his left shoulder. He presented to the emergency department for further evaluation. He was a tobacco user and there was no family history of coronary disease. On examination, he did not have any bruising over his chest. His chest was tender to palpation. Laboratory tests were significant for troponin T of 0.8 ng/mL (normal <0.01 ng/mL). Twelve-lead ECG revealed age indeterminate inferior infarct (Figure 1). Chest radiograph did not reveal any evidence of rib fractures. A preliminary diagnosis of cardiac contusion was made. Cardiac MRI was performed to evaluate for cardiac contusion. Cardiac MRI revealed no evidence of contusion. However, there was inferior, inferoseptal wall akinesis ( Blunt trauma to the chest has cardiac implications. Cardiac contusion, coronary dissection, coronary artery intramural hematoma, epicardial hematoma, and commotio cordis are some disease entities that occur secondary to blunt trauma. 1Myocardial infarction after blunt trauma can be secondary to dissection, intramural hematoma, or extrinsic compression from hematoma. Coronary intramural hematoma is a rare complication after blunt trauma, other causes being iatrogenic during percutaneous coronary intervention, spontaneous and retrograde propagation of aortic dissection. Hemorrhage in the vessel wall occurs because of the rupture of vasa vasorum and leads to hematoma formation in the medial-adventitial layers. This entity is distinguished from coronary dissection by the absence of intimal flap. Intravascular ultrasound is the mainstay modality to diagnose intramural hematomas and to differentiate from dissection.2 The most common coronary artery to be involved in blunt trauma is the left anterior descending artery, followed by right coronary artery 3 and left circumflex artery.3 Very few reports of coronary intramural hematomas secondary to blunt trauma have been published. 4 Our case is unique in that cardiac MRI performed to assess for contusion revealed evidence of transmural infarction in the right coronary artery territory. This prompted emergent coronary angiography. Intravascular ultrasound performed during angiography further characterized the mechanism of myocardial infarction. Elevated cardiac biomarkers can be seen both with contusion, and with vessel injury, as well. Multimodality assessment in patients experiencing blunt trauma can characterize the type of myocardial injury and expedite appropriate therapy. DisclosuresNone. References

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Blunt Cardiac Injury

Cited by 37 publications

References 58 publications

Paediatric chest wall trauma causing delayed presentation of ventricular arrhythmia

Paediatric chest wall trauma causing delayed presentation of ventricular arrhythmia

Tricuspid and Mitral Valve Regurgitation with Bi-fascicular Block Following a Horse Kick

Myocardial Injury After Blunt Trauma

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