Document Detail


Concrete induced cardiac contusion.
MedLine Citation:
PMID:  9391297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A previously fit 22 year old man was struck in the chest by a concrete block dropped through the windscreen of his car while he was driving on the motorway. He suffered extensive chest wall trauma and lung contusion, which subsequently precipitated acute respiratory distress. On admission ECG showed right bundle branch block and left axis deviation. Three days later QRS duration was normal but there was anterior ST segment elevation and subsequent T wave change. There was a large rise in creatine kinase, and echocardiography revealed septal and apical hyokinesis as well as a mobile mass attached to the left side of the interventricular septum, which had the echogenic texture of myocardium. The patient had fixed perfusion defects in the areas of hypokinesis on thallium scanning but the coronary arteries were unobstructed at angiography. He was treated with warfarin in the short term and an angiotensin converting enzyme inhibitor in the longer term and has made an asymptomatic recovery. Outpatient echocardiography two months after the injury demonstrated some recovery in overall left ventricular systolic function and no evidence of the intracardiac mass. This case illustrates some of the typical features of non-fatal cardiac contusion associated with non-penetrating cardiac trauma, and was complicated by partial thickness avulsion of a strip of the myocardium in the interventricular septum.
Authors:
N Curzen; S Brett; K Fox
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  78     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-12-17     Completed Date:  1997-12-17     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  313-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Royal Brompton Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic*
Adult
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Contusions / etiology*,  physiopathology,  ultrasonography
Echocardiography
Electrocardiography
Heart Injuries / etiology*,  physiopathology,  ultrasonography
Humans
Lung Injury
Male
Multiple Trauma / etiology*,  physiopathology,  ultrasonography
Respiration, Artificial
Warfarin / therapeutic use
Wounds, Nonpenetrating / physiopathology,  ultrasonography*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 81-81-2/Warfarin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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