Unstable cardiac injury complicated with septic shock—a challenge

Oxford University Press (OUP) - 2016
Neha Garg1, Kapil Dev Soni2, Richa Aggarwal2
1Department of Anaesthesia and Intensive Care All India Institute of Medical Sciences Ansari Nagar East, Gautam Nagar 110029 New Delhi, India
2Division of Critical & Intensive care All India Institute of Medical Sciences Ansari Nagar East, Gautam Nagar 110029 New Delhi, India

Tóm tắt

Abstract Background Road traffic accident accounts for 70 % to 80 % of the blunt cardiac injury. The true incidence varies in the literature due to non-uniform criteria for diagnosis. Case Presentation Here, we describe the case of a young male presenting after blunt chest injury and hemodynamic instability. Initially, the patient had frequent episodes of arrhythmias and hypotension due to cardiac injury per se. However, he was stabilized by day 2. Subsequently, patient developed cellulitis followed by septic shock and succumbed to cellulitis on day 5 of injury. Conclusion Sepsis is difficult to be diagnosed and treated in the presence of cardiac injury. Myocardial depression has been found in sepsis, which contributes as an added comorbidity in an already compromised heart function. Sepsis also interferes with the diagnosis and follow-up of progress of blunt cardiac injury.

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Tài liệu tham khảo

Wijngaarden, 1997, Blunt cardiac injury: a 10 year institutional review, Injury, 28, 51, 10.1016/S0020-1383(96)00118-0

Maenza, 1996, A meta-analysis of blunt cardiac trauma: ending myocardial confusion, Am J Emerg Med, 14, 237, 10.1016/S0735-6757(96)90165-5

Feghali, 1995, Blunt myocardial injury, Chest, 108, 1673, 10.1378/chest.108.6.1673

Asensio, 1998, One hundred five penetrating cardiac injuries: a 2 year prospective evaluation, J Trauma, 44, 1973, 10.1097/00005373-199806000-00022

Salim, 2001, Clinically significant blunt cardiac trauma: role of serum troponin levels combined with electrocardiographic findings, J Trauma, 50, 237, 10.1097/00005373-200102000-00008

Fernandez, 1998, Role of transesophageal echocardiography in the assessment of patients with blunt chest trauma: correlation of echocardiographic findings with the electrocardiogram and creatine kinase monoclonal antibody measurements, Am Heart J, 135, 476, 10.1016/S0002-8703(98)70324-2

Velmahos, 2003, Normal electrocardiography and serum troponin I levels preclude the presence of clinically significant blunt cardiac injury, J Trauma, 54, 45, 10.1097/00005373-200301000-00006

Mohammed, 2011, The clinic al significance of cardiac troponins in medical practice, J Saudi Heart Assoc, 23, 3, 10.1016/j.jsha.2010.10.001

Skorton, 1983, Quantitative texture analysis in two-dimensional echocardiography: application to the diagnosis of experimental myocardial contusion, Circulation, 68, 217, 10.1161/01.CIR.68.1.217

Krishnagopalan, 2002, Myocardial dysfunction in the patient with sepsis, Curr Opin Crit Care, 8, 376, 10.1097/00075198-200210000-00003

Ashraf, 2012, Cardiac functions in patients with sepsis and septic shock, Egyptian Heart J, 64, 191, 10.1016/j.ehj.2012.07.002

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