Ventricular tachycardia in an ice-hockey player after a blunt chest trauma

Schaer, Beat; Oßwald, Stefan; Sticherling, Christian; Tartini, R; Pfisterer, M

doi:10.1016/j.ijcard.2005.11.074

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…Few cases of VT after blunt chest trauma have been described. 8,9 RV dilation many years after chest trauma has also been described, 10 but to our knowledge, this is the first description of monomorphic VT many years after trauma from electroanatomically confirmed transmural scar. Several important findings from this case warrant emphasis.…”

Section: Discussionmentioning

confidence: 74%

“…When the trauma occurs during electrical susceptibility it may even cause ventricular fibrillation (commotio cordis). Few cases of VT after blunt chest trauma have been described 8,9 . RV dilation many years after chest trauma has also been described, 10 but to our knowledge, this is the first description of monomorphic VT many years after trauma from electroanatomically confirmed transmural scar.…”

Section: Discussionmentioning

confidence: 81%

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Ventricular Tachycardia from Remote Blunt Chest Trauma: Combined Epicardial‐Endocardial Right Ventricular Substrate Characterization

Michowitz¹,

Tung²,

Athill

et al. 2012

Pacing Clinical Electrophis

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Ventricular tachycardia as a late complication of blunt chest trauma has never been reported. We present a case of combined endocardial and epicardial delineation of the right ventricular arrhythmogenic substrate, where other causes of cardiomyopathy were excluded. The epicardial scar was more extensive than endocardial scar, and the central isthmus was likely intramural. A history of blunt chest trauma should be considered in patients with right ventricular cardiomyopathy.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 81%

Ventricular Tachycardia from Remote Blunt Chest Trauma: Combined Epicardial‐Endocardial Right Ventricular Substrate Characterization

Michowitz¹,

Tung²,

Athill

et al. 2012

Pacing Clinical Electrophis

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“…Blunt cardiac injury to the chest may cause direct cardiac arrhythmia, as in commotio cordis when an abrupt blow to the chest, delivered at a vulnerable phase of ventricular excitability, results in a fatal ventricular arrhythmia [2], versus delayed ventricular arrhythmias due to cardiac contusion and the formation of scar tissue [3]. Arrhythmia from blunt chest trauma can also secondarily be due to pneumothorax, the incidence of which depends on the severity of the trauma, exceeding 30% in some reports [4].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

Haq

Omar

2014

Case Reports in Cardiology

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Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations.

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“…We performed a systematic literature review for such cases and only identified 7 instances of chronic sustained VT development from a remote blunt chest wall injury. Nonetheless, it is important to note that RV aneurysm development rarely results in the development of ventricular tachycardia [ 13 , 14 , 16 ]. Patients that do develop abnormal ventricular substrate leading to VT beyond the acute injury phase appear to require an aggressive management and treatment approach.…”

Section: Review Of Ventricular Arrhythmia Mechanisms In Blunt Chesmentioning

confidence: 99%

Mechanisms and Clinical Management of Ventricular Arrhythmias following Blunt Chest Trauma

Wolbrom

Rahman

Tschabrunn

2016

Cardiology Research and Practice

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Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can be the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor vehicle accidents or traumatic falls. In this setting, the manifestation of ventricular arrhythmias has been observed both acutely and chronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation can occur immediately after chest wall injury (commotio cordis) and requires rapid defibrillation. Monomorphic ventricular tachycardia can develop in the chronic stage due to underlying structural heart disease long after blunt chest injury. The associated arrhythmogenic tissue may be complex and provides the necessary substrate to form a reentrant VT circuit. Ventricular tachycardia in the absence of overt structural heart disease appears to be focal in nature with rapid termination during ablation. Regardless of the VT mechanism, patients with recurrent episodes, despite antiarrhythmic medication in the chronic stage following blunt chest injury, are likely to require ablation to achieve VT control. This review article will describe the mechanisms, pathophysiology, and treatment of ventricular arrhythmias that occur in both the acute and chronic stages following blunt chest trauma.

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Ventricular tachycardia in an ice-hockey player after a blunt chest trauma

Cited by 6 publications

References 5 publications

Ventricular Tachycardia from Remote Blunt Chest Trauma: Combined Epicardial‐Endocardial Right Ventricular Substrate Characterization

Ventricular Tachycardia from Remote Blunt Chest Trauma: Combined Epicardial‐Endocardial Right Ventricular Substrate Characterization

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

Mechanisms and Clinical Management of Ventricular Arrhythmias following Blunt Chest Trauma

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