1/7. Sudden death from contusion of the right atrium after blunt chest trauma: case report and review of the literature.Occult cardiac injury following blunt trauma is more common than generally suspected. Myocardial lesions range from myocardial contusion to cardiac rupture. Myocardial contusion is not uncommon, it is usually a benign disorder which often remains undiagnosed. We report the case of a previously healthy 29-year-old man who was involved in a fight and suffered from blunt heart injury leading to contusion of the right atrium. The patient died soon after the injury and before admission to the Hospital. The diagnosis was made at autopsy. The present case is of special interest because of the unusual eliciting event and the rarity of the contusion site (right atrium). It is reported in order to raise the index of suspicion in physicians treating patients involved in a fight and aid in prompt diagnosis of myocardial contusion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Cardiac surgical emergencies.Cardiac surgical emergencies are broken down into three categories: cardiac trauma, aortic dissection, and surgery for acute myocardial infarctions. Emphasis is given to describing the presentation of patients with such problems, and to the salient aspects of the clinical strategies for managing each problem. An important goal of each section is focusing the critical care physician on the early recognition of cardiac surgical emergencies and providing him with some rationale for instituting an expeditious plan of therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Is sternal bone marrow needle biopsy still a hazardous technique? Report of three further fatal cases.Three fatal cases of death following sternal bone marrow needle biopsy have come to the authors' attention in the past 10 years. The hazards of the technique may be related to the incongruous stylet guard-adjustment for the thickness and hardness of the sternal wall. All three cases involved suits for professional malpractice. Controversial aspects of these cases involving physician liability are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Cardiac injuries caused by blunt chest trauma in children.Two illustrative cases with different features of cardiac injury caused by blunt chest trauma are described. The first patient had mild and obscure symptoms, detected on physical examination, and required observation only. The second patient had acute pericardial tamponade, necessitating surgical treatment. We present the different medical procedures that should be taken into consideration in management of such cases, although continuous monitoring, repeated physical examination, electrocardiograms, chest x-rays, and echocardiography proved sufficient in managing our two children. It is important that physicians who provide care to children suffering from blunt chest trauma have increased awareness of possible cardiac injuries.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Treatment os severe atrial injuries.Four cases of severe atrial trauma are presented. These cases are unusual because of the magnitude of injury and because of their presentation in hospitals not usually involved in cardiac surgery. Three of the patients had blunt atrial injury. We found only 21 other successfully treated blunt atrial tears in our search of the world's literature. In patients with blunt atrial injuries, the setting of a high speed vehicle accident, significant chest trauma, hypotension, mental confusion and increased venous pressure should alert the emergency physician to the possibility of cardiac rupture. The use of simple operative techniques and the knowledge that most cardiac ruptures repaired successfully involve the atrium may help the surgeon produce a successful outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Myocardial injury due to lightning.The report deals with a 27-year-old male who was standing in a tent and was injured by lightning as it struck a tree about 1.5 m away. He immediately lost consciousness and exhibited ventricular fibrillation when the emergency physician arrived. A clinical picture of hypoxaemic brain damage emerged after initially successful resuscitation. brain death was diagnosed on the fifth day after injury. The discrete external findings (remaining arborescent skin marks) contrasted markedly with the severe thermal damage to the pectoral muscle and cardiac musculature found during the autopsy. The histological cardiac findings indicated severe acute myocardial infarction affecting virtually all parts of the myocardium.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Perforation of the right ventricle: a complication of blind placement of a chest tube into the postpneumonectomy space.We were asked to review a case from an outside hospital in which there was inadvertent perforation of the right ventricle during the percutaneous placement of a chest tube. We present the case in the hopes that by doing so, others will avoid such a complication in the future. After reviewing the case, it appeared that the complication occurred because the physician was not knowledgeable about the anatomy of the postpneumonectomy space and the physician failed to use the safest procedure in placing the tube.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |