The Importance of Electrocardiographic Screening in Cardiac Contusion after Blunt Chest Trauma: Case Reports

Yıl 2013, Cilt: 38 Sayı: 4, 754 - 758, 01.12.2013

Keziban Uçar Karabulut Hüseyin Narcı Başar Cander Mehmet Gül Çetin Duman

Öz

Tracking and monitoring of patients with blunt chest trauma, especially blunt trauma is very important. As in all kinds of trauma, cardiac contusion in isolated chest trauma may result in acute coronary syndromes. We describe two patients who present with acute coronary syndrome after blunt chest trauma. Their ECG confirmed ST elevations in the inferior derivations, medical therapies and coronary angiography were carried out. Coronary angiographies have revealed no pathology in the coronary arteries. Their conditions were considered to be related to cardiac contusion due to trauma and stress. Cardiac contusion may occur in isolated chest traumas; however, it should be remembered that acute coronary syndrome may develop along with stress after any kind of trauma.

Anahtar Kelimeler

Blunt chest trauma, cardiac contusion, ECG screening

Künt gögüs travmasından sonra kardiyak kontüzyon elektrokardiyografik görüntülemenin önemi: Olgu sunumları

Öz

Künt göğüs travması geçiren hastaların takip ve monitorizasyonu önemlidir.İzole künt göğüs travmasına bağlı kardiyak kontüzyon takiben akut koroner sendrom gelişebileceği unutulmamalıdır. Künt göğüs travması sonucu akut koroner sndrom gelişen iki hasta tanımlamaya çalıştık.Hastarın EKG lerinde inferior derivasyonlarda ST elevasyonu tespit ettik,hastalar medikal tedavi ve koroner anjiografi yapıldı. koroner anjiografi sonucu koroner arterlerde herhangi bir patoloji saptanmadı.Onların durumu, travma ve stres nedeniyle kardiyak kontüzyona bağlandı.Kardiyak kontüzyon izole künt göğüs travmalarında oluşabilir, bununla birlikte hertürlü travma ve stres sonucu akut koroner sendromu gelişebileceği unutulmamalıdır.

Anahtar Kelimeler

Künt göğüs travması, kardiyak kontüzyon, EKG görüntüleme

Kaynakça

• Girişgin AS, Cander B,Gederet YT, Ağralı Y.The rol of cTnI, in detectin of etiological factors of cardiac contusion. Turkish Journal of Trauma and Emergency Surgery. 2002;8:82-5
• Vougiouklakis T, Peschos D, Doulis A, Batistatou A, Mitselou A, Agnantis NJ. Sudden death from contusion of the right atrium after blunt chest trauma: case report and review of the literature. Injury. 2005; 36:213-7.
• Rudusky BM. Classification of myocardial contusion and blunt cardiac trauma. Angiology. 2007;58:610-3
• Gerard O, Pierre M, Edo K, Muhamed S. Acute myocardial infarction due to left anterior descending coronary artery dissection after blunt chest trauma. J Emerg Radiol. 2010; 2:149-51
• Nakamura T, Maloney JD, Osaki S. Traumatic pericardial rupture without cardiac injury.Gen Thorac Cardiovasc Surg. 2008; 56:602-5.
• Bertinchant JP, Polge A, Mohty D, Nguyen-NgocLam R, Estorc J, Cohendy R et al. Evaluation of incidence, clinical significance, and prognostic value of circulating cardiac troponin I and T elevation in hemodynamically stable patients with suspected myocardial contusion after blunt chest trauma. J Trauma. 2000; 48:924-31.
• Peter J, Kirchner A, Kuhlisch E, Menschikowski M, Neef B, Dressler J . The relevance of the detection of troponins to the forensic diagnosis of cardiac contusion. Forensic Sci Int. 2006; 160:127-33.
• Seval İzdeş, Erdal Özcan, Serpil Taştan, Orhan Kanbak. Kardiyak Kontüzyon. Türk Anest Rean Der Dergisi. 2008; 36:261-65.
• Sybrandy KC, Cramer MJ, Burgersdijk C. Diagnosing cardiac contusion: old wisdom and new insights. Heart. 2003; 89:485-9.
• Sakka SG, Huettemann E, Giebe W, Reinhart K. Late cardiac arrhythmias after blunt chest trauma. Intensive Care Med. 2000; 26:792-5.
• Ghersin E, Khoury A, Litmanovich D, Lorber A, Halberthal M, Engel A. Comprehensive multidetector computed tomography assessment of severe cardiac contusion in a pediatric patient: correlation with echocardiography. J Comput Assist Tomogr. 2005; 29:739-41.
• Yazışma Adresi / Address for Correspondence: Dr. Keziban Uçar Karabulut Baskent University Medical Faculty, Emergency Department Hocacihan Mah. Saray Cad. No 1 Selçuklu/ KONYA e-mail: [e-mail] geliş tarihi/received :25.12.2012 kabul tarihi/accepted:21.01.2013