Transient electrocardiographic abnormalities following blunt chest trauma in a child

Abstract

Blunt cardiac injury may occur in patients after suffering nonpenetrating trauma of the chest. It encompasses a wide spectrum of cardiac injury with varied severity and clinical presentation. Electrocardiographic abnormalities are frequently encountered. This article presents a case of a child who presented with complete right bundle branch block on the initial ECG at the emergency department. She suffered blunt chest trauma during a horseback riding accident. She was admitted for cardiac monitoring. The electrocardiographic abnormalities resolved within 12 hours. No signs of myocardial injury were found on repeat serum troponin measurement and echocardiography. The natural history of ECG abnormalities in the pediatric age group following blunt chest trauma is limited. Although a complete right bundle branch block may be transient in adult patients, this has not been previously reported in a children. Significant ECG abnormalities can be encountered in children following blunt chest trauma. Although a complete RBBB can be associated with severe injury to the RV, it can also occur with minor injury.

Transient complete right bundle branch block following right heart catheterization in children – a report of two cases

“…Transient blocks are rarely reported in children. There are reports of transient RBBB following cardiac catheterization for electrophysiological studies [6, 7] and both transient RBBB and complete heart block, after a blunt chest trauma [8, 9] – the latter one showing that damage to the conduction tract can be caused not only by a direct trauma and can be associated with edema of the conductive tissue. The conduction disturbances discussed in the literature lasted from several minutes to 24 h [4, 7].…”