Cardiac contusion: Difference between revisions
Line 35: | Line 35: | ||
Observation for 6 hours | Observation for 6 hours | ||
Admit ( | ===Admit for (telemetry bed):=== | ||
#abnl physical | #abnl physical | ||
#abnl ekg | #abnl ekg |
Revision as of 14:31, 22 July 2015
Background
- MVC with chest striking the steering wheel
Clinical Features
- Chest pain
- Palpitations
- Tachy
- Dyspnea/SOB
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Diagnosis
- Physical
- New murmur
- EKG
- most common abnormality in order
- Sinus tachy
- PVCs
- A. fib
- Dysrythmia can be delayed for up to 12 hours
- most common abnormality in order
- Do NOT need enzymes but can help dx
- Positive Trop
- Echo
- Can aid in further determining the extent of damage
Treatment
- Treat arrhythmia prn
- Do NOT treat prophylacticly (increased mortality!)
- NO thrombolitics for AMI here (increased mortality)
severity depends on underlying CAD because of inflammatory changes= redistribute coronary flow that may= ischemic cp.
Disposition
Observation for 6 hours
Admit for (telemetry bed):
- abnl physical
- abnl ekg
- hypotension