Document Detail

True-true, unrelated: a case report.
MedLine Citation:
PMID:  16280951     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Sudden cardiac deaths in previously healthy children are frequently due to undiagnosed cardiovascular diseases, either congenital or acquired. In an uncommon clinical entity known as commotio cordis, sudden death from cardiac arrest can occur in young athletes after a blunt blow to the chest, in the absence of preexisting cardiovascular disease. We present a case in which the clinician's high index of suspicion leads to the diagnosis of acute myocarditis in a patient whose sudden cardiac deterioration was initially attributed to the result of recent blunt chest trauma. METHODS: A case report and review of literature via MEDLINE (1996-2004) search using the key words "myocarditis," "commotio cordis," and "myocardial contusion." RESULTS: A 12-year-old boy was admitted with elevated cardiac enzymes and respiratory distress after being hit in the chest with a dodgeball. Shortly after admission, the patient developed refractory ventricular arrhythmia, which was thought to be the result of blunt chest trauma. Further evaluation with endomyocardial biopsy, however, demonstrated acute myocarditis as the true etiology, for which the patient received immunosuppressive treatment. Unfortunately, the patient eventually required cardiac transplantation because of progressive irreversible cardiac dysfunction due to myocarditis. CONCLUSIONS: Although acute myocarditis, commotio cordis, and myocardial contusion can all present with malignant ventricular arrhythmia, other clinical features and approaches to management of each disease are very different. This case illustrates the importance of having a broad differential diagnosis in mind when presented with a previously healthy child in sudden cardiogenic shock.
Deyin D Hsing; Andranik Madikians
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Pediatric emergency care     Volume:  21     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-10     Completed Date:  2006-08-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  755-9     Citation Subset:  IM    
Division of Pediatric Critical Care, Department of Pediatrics, Mattel Children's Hospital, University of California, Los Angeles, CA, USA.
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MeSH Terms
Acute Disease
Athletic Injuries / complications*
Cardiomegaly / etiology
Chest Pain / etiology
Contusions / diagnosis*
Diagnosis, Differential
Diagnostic Errors*
Dyspnea / etiology*
Extracorporeal Membrane Oxygenation
Heart Arrest / etiology*
Heart Catheterization
Heart Injuries / diagnosis*
Heart Transplantation
Myocarditis / complications,  diagnosis*,  surgery
Myocardium / pathology
Pulmonary Edema / etiology
Tachycardia, Ventricular / etiology
Thoracic Injuries / complications*

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

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