1/12. Myocardial contusion presented as acute myocardial infarction after chest trauma.A 46-year-old male patient developed an acute myocardial infarction and congestive heart failure following blunt chest trauma. Electrocardiogram (ECG) revealed acute anterior myocardial infarction. echocardiography showed akinesis of interventricular septum, dyskinesis in apical anterior wall, and severe impairment of left ventricular overall systolic function. coronary angiography revealed normal coronary arteries. The patient followed a low-intensity physical medicine rehabilitation program. Follow-up was without new complications or deterioration of congestive heart failure. Five months later the patient presented with fulminant acute pulmonary edema and cardiogenic shock. cardiopulmonary resuscitation was unsuccessful.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/12. Amyloid myopathy: evidence for mechanical injury to the sarcolemma.Myopathy is a rare clinical manifestation in primary systemic amyloidosis. The clinical phenotype and muscle histology are well described but the pathophysiological mechanisms remain poorly understood. We report a 40-year-old man who presented with hypertrophic cardiomyopathy and a limb girdle syndrome associated with deposition of amyloid and free lambda light chains in skeletal muscle. Electron microscopy showed amyloid fibrils, physically disrupting the plasma membrane and basal lamina, while laminin immunocytochemistry revealed a reduction of laminin beta1 and upregulation of laminin alpha1. We believe that one of the possible pathophysiological mechanisms in amyloid myopathy is mechanical disruption of the sarcolemma by the abutting amyloid fibrils.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/12. Traumatic aortic and mitral valve injury following blunt chest injury with a variable clinical course.Blunt trauma is uncommonly followed by intracardiac valvar injuries. The resulting valvar insufficiency rapidly or progressively leads to congestive heart failure or death unless surgically corrected. Three patients with sustained blunt chest trauma were found to have two aortic valve and one mitral valve ruptures. They had variable clinical courses. However, after the diagnosis was established, surgical intervention was attempted promptly, which consisted of two aortic valve replacements and one mitral valvoplasty. Their postoperative courses were uneventful. Careful observation and repeated physical examination, aided by echocardiography, were required after the blunt chest trauma.- - - - - - - - - - ranking = 11.284717787422keywords = physical examination, physical (Clic here for more details about this article) |
4/12. Cardiac perforation 6 weeks after percutaneous atrial septal defect repair using an Amplatzer septal occluder.A 14-year-old boy presented to the emergency department unaccompanied by his parents with a decreased level of consciousness, bradycardia, and hypotension after a syncopal episode. The patient's electronic chart revealed a percutaneous closure of a secundum atrial septal defect using an Amplatzer septal occluder (AGA Medical, Golden Valley, MN) 6 weeks before this presentation. An urgent echocardiogram revealed a moderate pericardial effusion, and 320 mL of fresh blood was evacuated by subxiphoid pericardiocentesis. The child underwent surgical exploration and was found to have a perforation in the superior-posterior aspect of the right atrium, which was corrected. The septal occluder was extracted, and the atrial septal defect was closed with a pericardial patch. This case illustrates a rare but life-threatening complication of percutaneous closure of atrial septal defect using an Amplatzer septal occluder and the importance of timely access to patient records when available history and physical examination are limited.- - - - - - - - - - ranking = 11.284717787422keywords = physical examination, physical (Clic here for more details about this article) |
5/12. Successfully treated cardiac luxation through right pericardium.A 54-year old laborer suffering from multiple thoracic injuries on his 16th hospital day during the gypsum bandage for his left shoulder suddenly developed circulatory collapse. Emergency angiocardiogram revieled this is caused by cardiac luxation through the right side pleuropericardium. Reposition of the heart and repair of pericardium resulted in normalization of circulatory physiology. Later, he returned to good and active physical condition.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/12. 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 = 22.569435574844keywords = physical examination, physical (Clic here for more details about this article) |
7/12. Ventricular septal defect following blunt chest trauma in childhood: a case report.We report a case of a six-year-old male who sustained a ventricular septal defect following blunt trauma to the chest. Traumatically acquired VSD is rare in children. The diagnosis is made by characteristic history and physical examination and confirmed by echocardiogram or cardiac catheterization. Treatment is medical until surgical repair can be safely accomplished.- - - - - - - - - - ranking = 11.284717787422keywords = physical examination, physical (Clic here for more details about this article) |
8/12. Right ventricular outflow obstruction secondary to right-sided tamponade following myocardial trauma.A case of isolated tamponade of the right side of the heart, seen as an abrupt change in the cardiac silhouette and as right ventricular outflow obstruction following myocardial trauma, is presented, along with a review of the English-language literature on delayed postoperative tamponade and loculated pericardial effusion. The importance of a low, fixed cardiac output and nonspecific physical findings in suggesting the clinical diagnosis is emphasized. The absence of many of the classic signs and symptoms of pericardial tamponade is noted, as is the possibility of unusual changes in the appearance or function of the heart in the presence of a loculated effusion. Finally, the differential diagnosis and the results of a variety of diagnostic techniques are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/12. Traumatic acute mitral regurgitation secondary to blunt chest trauma.An 18-yr-old male involved in a motor vehicle accident developed acute traumatic mitral regurgitation with fulminant pulmonary edema and death. He had prominent V waves on his pulmonary arterial trace, a history of chest trauma, frothy pink pulmonary edema, and elevated pulmonary artery, wedge, and CVP. His ECG was normal and physical exam was negative for a typical murmur. He was on a ventilator and had copious secretions, making the diagnosis of a murmur difficult. A high index of suspicion is necessary when any patient is admitted with a history of chest trauma so that the diagnosis of a ruptured mitral valve is not missed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/12. Traumatic rupture of the pericardium.patients with traumatic rupture of the pericardium rarely survive to reach a hospital. Ten cases from the maryland Institute for emergency medical services Systems and 132 previously published cases are reviewed. patients were usually men who were victims of violent thoracic trauma. The median age was 40 years. Half of the patients had left pleuropericardial tears; tears of the diaphragmatic pericardium, right pleuropericardium, and superior mediastinal pericardium were less frequent. Associated injuries of the heart or left hemidiaphragm were common. Pericardial rupture was usually discovered during surgical exploration for other indications, but physical or radiographic signs were occasionally present. Repair is indicated for most pericardial tears to prevent herniation of the heart or abdominal viscera.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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