Cardiac contusion - Revision history

Rossdonaldson1: /* Background */

2019-08-17T20:58:55Z

Background

← Older revision		Revision as of 20:58, 17 August 2019
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	==Background==		==Background==
	**Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)		*Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)
	*Range is due to lack of standardized diagnostic criteria.		*Range is due to lack of standardized diagnostic criteria.
	*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>		*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>

Rossdonaldson1: /* Background= */

2019-08-17T20:58:41Z

Background=

← Older revision		Revision as of 20:58, 17 August 2019
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	=Background==		==Background==
	**Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)		**Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)
	*Range is due to lack of standardized diagnostic criteria.		*Range is due to lack of standardized diagnostic criteria.

Rossdonaldson1: /* Background */

2019-08-17T20:58:20Z

Background

← Older revision		Revision as of 20:58, 17 August 2019
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	==Background==		=Background==
	**Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)		**Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)
	**Range is due to lack of standardized diagnostic criteria.		*Range is due to lack of standardized diagnostic criteria.
	*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>		*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>

	~~{{Background BCI}}~~

	===Mechanism of injury===		===Mechanism of injury===
	*MVC is common, but [[crush injuries]], [[CPR]] and others have also been described.		*MVC is common, but [[crush injuries]], [[CPR]] and others have also been described.
	*Can occur with decelerations from as little as less than 20mph<ref name="El-Chami" />		*Can occur with decelerations from as little as less than 20mph<ref name="El-Chami" />

			{{Background BCI}}

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Background */

2019-08-17T20:55:02Z

Background

← Older revision		Revision as of 20:55, 17 August 2019
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	==Background==		==Background==
	*~~Cardiac contusion~~ is on the ~~spectrum~~ of [[~~Blunt~~ cardiac injury]] (BCI), which ranges from mild contusion to cardiac rupture.<ref name="El-Menyar">El-Menyar A, Al Thani H, Zarour A, Latifi R. Understanding traumatic blunt cardiac injury. Ann Card Anaesth. 2012 Oct-Dec;15(4):287-95. doi: 10.4103/0971-9784.101875.</ref>		**Contusion is the most common type of [[blunt cardiac injury]] (60-100%) (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)
	**Contusion is the most common of these, found in 60-100% ~~of all blunt cardiac injury.~~ (Other sources cite lower figures of 8-76%<ref name="Emet" /><ref name="El-Chami">El-Chami MF, Nicholson W, Helmy T. Blunt cardiac trauma. J Emerg Med. 2008 Aug;35(2):127-33.</ref>)
	**Range is due to lack of standardized diagnostic criteria.		**Range is due to lack of standardized diagnostic criteria.
	*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>		*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>

Rossdonaldson1: /* Background */

2019-08-17T20:54:01Z

Background

← Older revision		Revision as of 20:54, 17 August 2019
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	**Range is due to lack of standardized diagnostic criteria.		**Range is due to lack of standardized diagnostic criteria.
	*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>		*Autopsy shows patchy necrosis and hemorrhage of damaged areas of myocardium and is the "gold standard" for research<ref name="Emet">Emet M, Saritemur M, Altuntas B, et al. Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED. Am J Emerg Med. 2015 Jun;33(6):865.e1-3. doi: 10.1016/j.ajem.2014.12.059.</ref>

			{{Background BCI}}

	===Mechanism of injury===		===Mechanism of injury===

Rossdonaldson1: Text replacement - "Troponin" to "Troponin"

2019-07-01T21:00:25Z

Text replacement - "*Troponin" to "*Troponin"

← Older revision		Revision as of 21:00, 1 July 2019
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	*[[Cardiac enzymes]] (Troponin, CK-MB)<ref name="Sybrandy" />		*[[Cardiac enzymes]] (Troponin, CK-MB)<ref name="Sybrandy" />
	**CK-MB is neither sensitive nor specific		**CK-MB is neither sensitive nor specific
	**Troponin is specific for cardiac injury, but not sensitive for cardiac contusion		**[[Troponin]] is specific for cardiac injury, but not sensitive for cardiac contusion

	==Management==		==Management==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T07:55:21Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 07:55, 23 July 2016
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	{{Thoracic trauma DDX}}		{{Thoracic trauma DDX}}

	==~~Diagnosis~~==		==Evaluation==
	''Diagnosis is difficult due to spectrum of clinical disease and lack of adequate test in the ED''		''Diagnosis is difficult due to spectrum of clinical disease and lack of adequate test in the ED''
	*Physical exam		*Physical exam

Rossdonaldson1: Text replacement - "SOB" to "shortness of breath"

2016-07-15T20:19:11Z

Text replacement - "SOB" to "shortness of breath"

← Older revision		Revision as of 20:19, 15 July 2016
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	*[[Palpitations]]		*[[Palpitations]]
	*[[Tachycardia]]		*[[Tachycardia]]
	*[[Dyspnea]]/[[~~SOB~~]]		*[[Dyspnea]]/[[shortness of breath]]

	==Differential Diagnosis==		==Differential Diagnosis==

Neil.m.young: Text replacement - "Pts " to "Patients "

2016-07-11T14:47:35Z

Text replacement - "Pts " to "Patients "

← Older revision		Revision as of 14:47, 11 July 2016
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	==Disposition==		==Disposition==
	*~~Pts~~ with mild injury, normal ECG, and negative Troponin can likely be discharged after period of observation<ref name="Sybrandy" />		*Patients with mild injury, normal ECG, and negative Troponin can likely be discharged after period of observation<ref name="Sybrandy" />
	*Admit to telemetry bed for:		*Admit to telemetry bed for:
	**Hemodynamic instability		**Hemodynamic instability

Neil.m.young: Text replacement - " pt " to " patient "

2016-07-02T09:29:29Z

Text replacement - " pt " to " patient "

← Older revision		Revision as of 09:29, 2 July 2016
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	===Prognosis===		===Prognosis===
	*Generally favorable prognosis		*Generally favorable prognosis
	*Even if pt has minor wall motion abnormality, mild arrhythmia, etc, these usually resolve within 1 day<ref>Bock JS, Benitez RM. Blunt cardiac injury. Cardiol Clin. 2012 Nov;30(4):545-55. doi: 10.1016/j.ccl.2012.07.001.</ref>		*Even if patient has minor wall motion abnormality, mild arrhythmia, etc, these usually resolve within 1 day<ref>Bock JS, Benitez RM. Blunt cardiac injury. Cardiol Clin. 2012 Nov;30(4):545-55. doi: 10.1016/j.ccl.2012.07.001.</ref>
	**Long-term sequelae are rare in hemodynamically stable patient without significant ECG abnormality		**Long-term sequelae are rare in hemodynamically stable patient without significant ECG abnormality
	**Severe cardiac contusion may rarely lead to ventricular remodeling and aneurysm		**Severe cardiac contusion may rarely lead to ventricular remodeling and aneurysm

Cardiac contusion - Revision history

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Background= */

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Background */

Rossdonaldson1: Text replacement - "*Troponin" to "*Troponin"

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

Rossdonaldson1: Text replacement - "SOB" to "shortness of breath"

Neil.m.young: Text replacement - "Pts " to "Patients "

Neil.m.young: Text replacement - " pt " to " patient "

Rossdonaldson1: Text replacement - "Troponin" to "Troponin"