Presentation
Topics covered include managing the patient with sepsis or septic shock; anesthetic considerations for patients in respiratory failure; anesthetic concerns in patients presenting with renal failure; perioperative management of patients with liver failure [books.google.de]
Cardiac rupture from blunt chest trauma is not a common presentation, and more so in the absence of rib or sternal fracture. We present a case of blunt chest trauma, who presented with features of cardiac tamponade. [jctt.org]
Visualization based on CT scan acquisition are presented combined with the results of macroscopic and microscopic examination. [paperity.org]
Hemopericardium or pericardial tamponade is the usual clinical presentation, and surgery is almost always necessary. [health.am]
Typically, patients present with hypovolemic shock and signs of peritonitis. [abdominalsurg.org]
Cardiovascular
- Heart Disease
Commotio cordis is sudden cardiac arrest that follows a blow to the anterior chest wall in patients who do not have pre-existing or traumatic structural heart disease. [merckmanuals.com]
Traumatic heart disease, in: zipes DP, Libby P, Bonow RO, Braunwald E, editors: braunwald's heart disease: a textbook of cardiovascular medicine. 7 th ed Philadelphia: Elsevier Saunders. 2005; 7: 1781-8. Google Scholar Guo H, Chi J, Yuan M, Qiu Y. [panafrican-med-journal.com]
And long-term emotional stress shortens lives by increasing the risk of heart disease, notes Daniel J. Brotman, MD, director of the hospitalist program at Johns Hopkins Hospital, Baltimore. [webmd.com]
[…] in which the immune system mistakenly attacks healthy tissues high levels of radiation to the chest hypothyroidism, which increases the risk for heart disease a heart attack kidney failure infections that affect the heart Cardiac tamponade has the following [healthline.com]
Attribution Author: Eric Berlin, MD Date Written: Editor: Ballenberg, Sally, BS Edit Date: 08/31/01 Reviewer: Eileen McLaughlin, RN, BSN Date Reviewed: 07/31/01 Sources Merck Manual 1999 Harrison's Principles of Internal Medicine 1991 Heart Disease: A [medicineonline.com]
Eyes
- Roth's Spots
Seite 128 - Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions Immunologic phenomena: glomerulonephritis, Osier's nodes, Roth spots, rheumatoid factor [books.google.de]
الصفحة 128 - Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions Immunologic phenomena: glomerulonephritis, Osier's nodes, Roth spots, rheumatoid factor [books.google.com]
Skin
- Janeway Lesion
Seite 128 - Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions Immunologic phenomena: glomerulonephritis, Osier's nodes, Roth spots, rheumatoid factor [books.google.de]
الصفحة 128 - Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions Immunologic phenomena: glomerulonephritis, Osier's nodes, Roth spots, rheumatoid factor [books.google.com]
Workup
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]
There are no pathognomonic findings; however, the presence of a new arrhythmia is a sign that workup needs to be escalated. [intechopen.com]
Radiologic workup revealed a bilateral pleural effusion, a fracture of the right collarbone, a hepatic contusion, a right adrenal hematoma and a fracture of the left iliac wing. [panafrican-med-journal.com]
While the majority of cases require little workup, it is crucial to identify those cases that warrant more extensive evaluation. Cases of life-threatening BCI, while rare, require urgent stabilization. [ahcmedia.com]
X-Ray
- Pericardial Effusion
Echocardiography evaluates wall motions, valvular function and ejection fraction and determines diagnoses of pleural-pericardial effusions and aortic injury. Our patient had pericardial effusion. [casereports.in]
Echocardiography is the main diagnostic method for detection of pericardial effusion and tamponade 4. [acls.com]
Summary echocardiography revealed mild systolic dysfunction without pericardial effusion. [elsevier.pt]
Probe Position for Parasternal Long View of Pericardial Effusion Figure 2. Parasternal Long View of Pericardial Effusion Figure 3. Probe Position for Subxiphoid View of Pericardial Effusion Parasternal long view of pericardial effusion. [ahcmedia.com]
A focal posterior effusion, seen on the parasternal long axis view, may be a left pleural effusion rather than a pericardial effusion. The hypoechoic stripe of a pericardial effusion usually wraps around the apex of the heart. [acep.org]
QT, RR, ST Intervals
- ST Elevation
Changes in Hospital Mortality Rates in 425 Patients with Acute ST-Elevation Myocardial Infarction and Cardiac Rupure Over a 30-Year Period. Circulation. 2008;118:2783–9. ^ a b Lin TH, Su HM, Voon WC, Lai HM, Yen HW, Lai WT, Sheu SH (2006). [en.wikipedia.org]
Initial assessment showed an ST segment elevation on ECG, along with multiple fractures and abdominal injuries. [panafrican-med-journal.com]
Treatment
Complications : chylothorax, chylopericardium, chylomediastinum Treatment : mostly surgical repair See diaphragmatic rupture for details. References: [5] [11] [12] [13] [14] [amboss.com]
Treatment & Monitoring What are the treatments for the condition? The goal of treatment is to control the symptoms. Treatments vary depending on how the heart has been damaged. [medicineonline.com]
Treatments Because traumatic aortic transection is a life-threatening condition, treatment is needed immediately. The most common treatment is endovascular treatment to repair the damaged area. [cedars-sinai.edu]
We offer: Modern facilities : A Level 1 Adult and Pediatric Trauma Center equipped with advanced imaging technology Emergency care : Surgeons on-call 24/7 for evaluating and treating traumatic aortic injury Advanced Treatments : The latest treatment options [heart.ucla.edu]
Your long-term outlook greatly depends on how quickly you get treatment. Seek medical treatment immediately if you think you have this condition. [healthline.com]
Prognosis
Asymptomatic – observation Symptomatic – surgical exploration and repair Cardiac rupture worst prognosis Only 20% survive 16. Central venous line Cardiac catheterization Coronary A. rupture Aortic dissection Pericardiocentesis Pericardial [slideshare.net]
Prognosis [ edit ] The prognosis of myocardial rupture is dependent on a number of factors, including which portion of the myocardium is involved in the rupture. [en.wikipedia.org]
[…] asymptomatic or unspecific findings (e.g., chest pain, dyspnea ) In case of rupture: signs of hemorrhagic shock ( tachycardia, hypotension ) Diagnostics Initial test: chest x-ray Mediastinal widening Tracheal deviation Hemothorax Further tests Treatment Prognosis [amboss.com]
Despite substantial progress in the detection, quantification, characterization, management, and prognosis of pericardial diseases, and the recent guidelines and recommendations, there is only limited evidence-based data to guide the management of pericardial [acls.com]
Right ventricular infarction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med. 1993 Apr 8;328(14):981-8. [teikyo-cvs.com]
Etiology
References: [1] [2] [3] [4] Blunt chest trauma Chest wall injury Etiology : mostly blunt trauma, pathologic fractures, nonaccidental trauma ( child abuse ) Clinical features Diagnostics Complications Pneumothorax Hemothorax Especially in the elderly: [amboss.com]
The most common etiology of LV pseudoaneurysm is AMI. (LV pseudoaneurysm is twice as common with inferior AMI as it is with anterior AMI.) LV pseudoaneurysms may also develop after surgical interventions, especially after mitral valve replacement. [emedicine.medscape.com]
[…] tomography can show pericardial positioning of a pacemaker lead, which, as well as pacemaker dysfunction, suggests late cardiac rupture. 8 Finally, pericardial effusion associated with infection of the pacemaker implantation site suggests a bacterial etiology [elsevier.pt]
Etiology and Pathophysiology In the past century advances in science and technology generally influenced quality and duration of human life positively. [ispub.com]
Epidemiology
Epidemiology Among the causes of death in all age groups, deaths due to trauma rank third after cardiovascular diseases and cancer ( 2 ). Recently, most common cause of death under age 40 is accidents. [ispub.com]
Pediatric blunt cardiac injury: Epidemiology, clinical features, and diagnosis. Pediatric Emergency Medicine Collaborative Research Committee: Working Group on Blunt Cardiac Injury. J Trauma 1996;40: 61-67. 36. Healey MA, et al. [ahcmedia.com]
Pathophysiology
Pathophysiology is unclear, but the timing of the blow in relation to the cardiac cycle may be important. Initial rhythm is usually ventricular fibrillation. [merckmanuals.com]
Regarding the pathophysiology of cardiac contusions, it appears the injury is caused by direct pressure on the myocardium and by indirect effects caused by increases in intrathoracic pressures with shear stress happening at the same time. [autoaccident.com]
Pathophysiology Blunt trauma can induce myocardial lesions by several mechanisms: (1) direct transfer of energy during the impact on the thorax; (2) rapid deceleration of the heart; and (3) compression of the heart between the sternum and the spine. [anesthesiology.pubs.asahq.org]
Etiology and Pathophysiology In the past century advances in science and technology generally influenced quality and duration of human life positively. [ispub.com]
Patients may demonstrate the pathophysiologic patterns of tamponade (see Chapter 19), left ventricular failure, right ventricular failure, acute VSD (see Chapter 15), acute valvular regurgitation (see Chapter 16), or MI. [tele.med.ru]
Prevention
To be consistent with the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [43], this level of BP will now be termed "prehypertensive" and is an indication for lifestyle modifications [books.google.de]
Lidocaine in the prevention of primary ventricular fibrillation: A double-blind, randomized study of 212 consecutive patients. N Engl J Med 1974;291: 1324-6. Página 366 - Modig J, Borg T, Karlstrom G, Maripuu E, Sahlstedt B. [books.google.es]
On occasion, open replacement surgery will be offered, thereby removing the damaged portion of the aorta and placing a graft where the tissue was removed in order to prevent blood from leaking from the aorta. [cedars-sinai.edu]