The patient presented with cardiogenic shock and was initially treated surgically for a large pneumothorax and cardiac tamponade. A few days later she presented with dyspnoea and hypotension. [ncbi.nlm.nih.gov]

Clinical Presentation and Diagnosis Most cardiac injuries caused by stab wounds are logically based on the trajectory of the insult. [thoracickey.com]

The 12.5% with lesions in more than one chamber presented 100% mortality. The present patient had a transfixing lesion that affected the right ventricle, with the projectile lodged inside this cardiac chamber. [scielo.br]

Valvular or septal injuries will often present with heart failure, and most will be associated with a loud, new murmur and/or hemodynamic instability. [nuemblog.com]

• Ecchymosis

  A history or findings of pain and tenderness over the anterior chest wall (which may be indistinguishable from a classic myocardial infarction), evidence of chest wall contusion, ecchymosis, anterior rib fractures, and flail chest are all associated with [thoracickey.com]

  Intimal disruption Thrombosis Dissection Signs & Symptoms: Symptoms: Most common symptom is chest pain Symptoms will widely depend on the extent of BCI Signs: Dysrhythmias (most commonly sinus tachycardia, atrial fibrillation) Chest wall deformities or ecchymosis [rebelem.com]

  Tachypnea, irregular lung sounds, chest wall tenderness, chest abrasion or ecchymosis, rib or sternal fractures, and seatbelt sign across the chest are some of the physical findings that should raise suspicion for BCI [10] although they are non-specific [ncbi.nlm.nih.gov]

  Jeff: Similarly, as concomitant injuries are common, inspect the abdomen, looking for ecchymosis patterns, which often accompany blunt cardiac injury. Nachi: Pretty standard stuff. Let’s move on to diagnostic testing. [ebmedicine.net]

• Congestive Heart Failure

  […] disease (RR, 4.31), and congestive heart failure (RR, 2.05). [medscape.com]

  These entities generally present with clinically significant acute congestive heart failure. Another rare entity is pericardial rupture with cardiac herniation. [intechopen.com]

• Surgical Procedure

  Definitive surgical procedure to manage TCI is surgical drainage of pericardial blood and repair of underlying cardiac injury. [jtraumainj.org]

  Keywords: Heart injuries; Wounds and Injuries; Wounds, Gunshot; Cardiac Surgical Procedures INTRODUCTION Despite advances in medicine that have high technology to support critical patients, penetrating cardiac injuries still pose a challenge to cardiothoracic [scielo.br]

• Swelling

  The usual treatment for a chest muscle strain is to reduce pain and swelling by following the "RICE" method: Rest : Avoid strenuous activities, especially those that caused or contributed to the muscle strain. [medicalnewstoday.com]

• Anemia

  Direct mechanical cardiac injury can be exacerbated by anemia and hypotension following hypovolemic shock, by raised intracranial pressure, and by hypoxia resulting from concomitant pulmonary injuries such as contusions, lacerations, and pneumothoraces [pubs.rsna.org]

• Heart Failure

  However, the diagnosis of heart failure was pre-existent to the stroke index event, which render neurogenic mechanisms less likely. We did not look at incident heart failure or other comorbidities after stroke. Despite this, as mentioned by Dr. [n.neurology.org]

  If a blunt injury to the heart causes other problems (such as heart failure or a damaged heart valve), people are admitted to the hospital, and the problem is treated. [msdmanuals.com]

  Impaired myocardial performance, which results from many factors, including hypoxia, is one of the main mechanisms responsible for heart failure in the critically ill patient. [ncbi.nlm.nih.gov]

  Clinical endpoints of death, cardiovascular death and heart failure. Heart failure will be defined by the diagnosis of clinical (symptomatic) heart failure 5. [isrctn.com]

• Hypotension

  A few days later she presented with dyspnoea and hypotension. An echo-Doppler study was performed and an acquired post-traumatic ventricular septal defect (VSD) with left-to-right shunt was diagnosed. [ncbi.nlm.nih.gov]

  Hypotension developed, with palpable BP dropping to 80 systolic at approximately minute 10 of the extrication. [jems.com]

  Cardiac injury can also be manifested by hemodynamic instability marked by refractory hypotension and elevated venous and cardiogenic shock. External jugular vein distention may be absent in cases of blood loss. [thoracickey.com]

  Because of its relative rarity, other cause of hypotension and/or arrhythmia should be ruled out before aggressively pursuing a diagnosis of cardiac contusion. [openanesthesia.org]

  Diagnosed at Autopsy. ii) Severe hypotension/heart failure with large areas of damage to myocardium, valves or pericardium. [echopraxis.com]

• Heart Disease

  These findings open a new avenue for therapeutic tools in Chagas' heart disease. [ncbi.nlm.nih.gov]

  We started with a search on cerebral findings in fetuses with congenital heart disease. [pediatrics.aappublications.org]

• Tachycardia

  Organ Injury Scaling Cardiac Grade Injury Description AIS-90 I Blunt cardiac injury with minor ECG abnormality (nonspecific ST or T wave changes, premature atrial or ventricular contraction or persistent sinus tachycardia) 3 Blunt or penetrating pericardial [trauma.org]

  […] persistent tachycardia is more suggestive of BCI rather than the transient tachycardia seen in the patient who is polytraumatized. [ncbi.nlm.nih.gov]

  Presenting symptoms may be non-specific, vary greatly, and appear attributable to coexisting injuries and/or pre-existing medical conditions including: chest pain dyspnea palpitations presyncope ECG Features on the electrocardiogram include 7 : sinus tachycardia [radiopaedia.org]

  the most common, to supraventricular arrhythmias such as atrial flutter and atrial fibrillation, ventricular tachycardia, premature ventricular contractions, ventricular fibrillation, right bundle branch block with first-degree heart block or hemiblock [thoracickey.com]

• Jugular Venous Distention

  Interestingly, Beck’s triad (muffled heart sounds, jugular venous distention, and hypotension) and Kussmaul’s sign (jugular venous distention with inspiration) are present in only 10% of patients 69 with pericardial tamponade. [thoracickey.com]

  Patients can present with cardiac tamponade, and suspicion should be high for jugular venous distention and hypotension. [ncbi.nlm.nih.gov]

• Contusion

  […] a diagnosis of myocardial contusion or blunt cardiac injury. [nuemblog.com]

  There are two general types of injuries of the heart, namely, contusions and wounds. Contusion of the heart results from blunt trauma, and this is probably the most frequent type of injury, as well as the most frequently overlooked. [jamanetwork.com]

  In myocardial contusion, there is a distinct boundary between normal and contused tissue. Patchy necrosis and hemorrhage eventually heal to form patchy and irregular fibrosis ( 3, 32 – 36 ). [pubs.rsna.org]

  Quick Information on Cardiac Contusion: Things to Know In this guide: What Is Cardiac Contusion Causes of Cardiac Contusion Symptoms of Cardiac Contusion Risk Factors for Cardiac Contusion Diagnosis of Cardiac Contusion Treatment of Cardiac Contusion [autoaccident.com]

  Myocardial contusion is not a specific diagnosis and the extent of the injury can vary greatly. [en.wikipedia.org]

• Muscle Strain

  The terms pulled muscle and muscle strain refer to an injury that involves an overstretched or torn muscle. A person with a muscle strain in the chest may experience sudden, sharp pain in this area. [medicalnewstoday.com]

• Stroke

  Dr Chen explained that while it is known that treating cardiovascular risk factors, such as hypertension, diabetes, and high cholesterol, reduces the risk for large-vessel cerebral disease (stroke), it has not been clear that treating heart failure or [medscape.com]

  Prenatally, a delay of cerebral development was most common; postnatally, white matter injury, periventricular leukomalacia, and stroke were frequently observed. [pediatrics.aappublications.org]

  Brain-heart interaction: Cardiac complications after stroke. Circ Res 2017;121:451-68. 11. Lim HB, Smith M. Systemic complications after head injury: A clinical review. Anaesthesia 2007;62:474-82. 12. [heartmindjournal.org]

  Similarly, Vogels et al. (32) showed that HF patients free from stroke, dementia, or depression had a higher prevalence of WM hyperintensities on brain MRIs. [onlinejacc.org]

The authors concluded that a cTnI greater than 1.05 µg/L necessitated further workup. Neither CK total or CK-MB were helpful in predicting BCI. [east.org]

Isolated sternal fracture is a risk factor for BCI and should prompt screening with ECG and troponin, but is not pathognomonic and does not mandate additional BCI workup on its own Patients with an abnormal ECG or an elevated troponin should be admitted [nuemblog.com]

There are no pathognomonic findings; however, the presence of a new arrhythmia is a sign that workup needs to be escalated. [intechopen.com]

Chest radiography is performed on hemodynamically stable patients, and a widened mediastinum signifies the need for further workup. [thoracickey.com]

Duration of treatment: 25 – 37 weeks Duration of follow-up: None Previous interventions: Breast cancer patients scheduled for anthracycline treatment will be approached to take part. [isrctn.com]

Treatment should be that of myocardial infarction; however, the diagnosis has to be suspected before treatment can be considered. [jamanetwork.com]

Treatment and recovery Treatment for a pulled chest muscle depends on the severity or grade of the injury. Treatment options include the following: RICE Avoiding physical activity can help aid recovery. [medicalnewstoday.com]

In this review we will describe the expanding understanding of intracellular MMP-2 biology, and how this knowledge may lead to improved treatments for ischemic heart injury. [ncbi.nlm.nih.gov]

Refractory cardiogenic shock can benefit from intra-aortic balloon pump (IABP) to help increase coronary blood flow, allowing the stunned heart to recover in days or weeks. [1] Prognosis Prognosis in blunt cardiac injury (BCI) is highly dependent on the [ncbi.nlm.nih.gov]

“The probability that they would have a positive stress test result is relatively low – less than 5 percent – and their medium-term prognosis is excellent,” Quyyumi says. [news.emory.edu]

They are generally well tolerated and may produce only minimal symptoms.[2] Prognosis is excellent both in-hospital and at 3 and 12 month follow up and patients who are initially clinically stable are very unlikely to deteriorate due to cardiac contusion [nuemblog.com]

BCI should be highly suspected when these other injuries are presents, and these other injuries may greatly affect the patients overall prognosis. [aast.org]

Although surgical mortality is almost 33%, survivors have demonstrated an excellent long-term prognosis ( 46 ). [pubs.rsna.org]

A common complication of these pulmonary events is pneumonia, whose most frequent etiologic agent in these cases is Staphylococcus aureus. [4], [10], [14] Pulse Rate and Blood Pressure When the surge of catecholamines increases, it causes hypertension [heartmindjournal.org]

The etiology of heart wounds is of extreme importance. Small pericardial and myocardial wounds with tamponade may be successfully treated by pericardiocentesis. [ncbi.nlm.nih.gov]

[…] injuries to the thorax, subcutaneous emphysema, flail chest and bony crepitus secondary to rib fractures may be present.6„ Pericardiocentesis may be attempted„by qualified providers as a temporizing maneuver for patients in extremis where the other etiologies [jems.com]

Etiology of Pericarditis in a Prospective Cohort of 1162 Cases. Am J Med. 2015 Jul;128(7):784.e1-8. Imazio M, Negro A, Belli R, Beqaraj F, Forno D, Giammaria M, Trinchero R, Adler Y, Spodick D. [escardio.org]

Other than the commonly recognized behavioral and psychological dysfunction, epidemiological studies have also revealed that PTSD patients have a higher risk of other diseases, such as cardiovascular disorders. [ncbi.nlm.nih.gov]

Co-authors at Emory include Laurence Sperling, MD, professor of medicine (cardiology) at Emory University School of Medicine and Viola Vaccarino, MD, PhD, Wilton Looney Chair of Cardiovascular Research and professor of epidemiology at Rollins School of [news.emory.edu]

Wityk, MD, emeritus, Johns Hopkins University School of Medicine, Baltimore, Maryland, writes, "The article by Hilal et al and others published in the recent literature suggest an important role of CMIs in epidemiologic studies of cerebrovascular disease [medscape.com]

Epidemiological and clinical characteristics as well as treatment of the patients are presented in Tables 2, 3 and 4. [sjtrem.biomedcentral.com]

This can range from mild to severe injuries including: Cardiac contusions Dysrhythmias after trauma Ventricular wall rupture Epidemiology: Estimated incidence of BCI in thoracic trauma varies greatly with reported values ranging from 8 to 71%. [rebelem.com]

Current evidence indicates that these cytokines are autocrine contributors to myocardial dysfunction and cardiomyocyte necrosis in I/R injury, whereas, earlier evidence also suggest that cytokines have controversial roles in cardiovascular pathophysiology [ncbi.nlm.nih.gov]

Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy. Int J Cardiol 2016;209:196-205. [heartmindjournal.org]

Mechanism, Pathophysiology, and Incidence In the civilian arena, penetrating cardiac injuries are primarily the result of gunshot and stab wounds. [thoracickey.com]

Central Illustration HF-Induced Brain Injury: Characteristics, Pathophysiology, and Approach The pathophysiology of brain injury in heart failure (HF) is multifactorial. [onlinejacc.org]

In this setting, different protective functions have been attributed to HSPs, which include repairing ion channels, restoring redox balance, interacting with nitric oxide-induced protection, inhibiting proinflammatory cytokines, and preventing apoptosis [ncbi.nlm.nih.gov]

The aim of this study is to test whether tablet medications called angiotensin receptor blockers (ARBs) and B-blockers can prevent heart muscle injury related to chemotherapy. [isrctn.com]

Mark Estes 3d, director of the Cardiac Electrophysiology Laboratory at the Tufts University School of Medicine, said measures that might prevent these sorts of fatalities "have not been rigorously established." [nytimes.com]

Colchicine for the prevention of postpericardiotomy syndrome. Herz. 2002 Dec;27(8):791-4. [escardio.org]