Abstract
A 45 year old farmer was kicked in the chest by a horse. In the days following the injury episodic breathlessness developed and he was admitted to hospital with right ventricular failure and pulmonary emboli. Echocardiography showed global right ventricular dysfunction but a right ventricular mural thrombus, the likely source of the pulmonary emboli, was not seen. He gradually recovered after treatment with anticoagulant. One month later he presented with a further complication—complete atrioventricular dissociation—that required a dual chamber pacemaker implantation.
This patient had few initial manifestations of right ventricular myocardial contusion and this case illustrates that such patients should be closely monitored for delayed complications.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Foil M. B., Mackersie R. C., Furst S. R., Davis J. W., Swanson M. S., Hoyt D. B., Shackford S. R. The asymptomatic patient with suspected myocardial contusion. Am J Surg. 1990 Dec;160(6):638–643. doi: 10.1016/s0002-9610(05)80764-0. [DOI] [PubMed] [Google Scholar]
- Frazee R. C., Mucha P., Jr, Farnell M. B., Miller F. A., Jr Objective evaluation of blunt cardiac trauma. J Trauma. 1986 Jun;26(6):510–520. doi: 10.1097/00005373-198606000-00004. [DOI] [PubMed] [Google Scholar]
- Gunnar W. P., Martin M., Smith R. F., Manglano R., Resnick D. J., Lopez V., Barrett J. A. The utility of cardiac evaluation in the hemodynamically stable patient with suspected myocardial contusion. Am Surg. 1991 Jun;57(6):373–377. [PubMed] [Google Scholar]
- Healey M. A., Brown R., Fleiszer D. Blunt cardiac injury: is this diagnosis necessary? J Trauma. 1990 Feb;30(2):137–146. [PubMed] [Google Scholar]
- Liedtke A. J., DeMuth W. E., Jr Nonpenetrating cardiac injuries: a collective review. Am Heart J. 1973 Nov;86(5):687–697. doi: 10.1016/0002-8703(73)90349-9. [DOI] [PubMed] [Google Scholar]
- Timberlake G. A., McSwain N. E., Jr Thromboembolism as a complication of myocardial contusion: a new capricious syndrome. J Trauma. 1988 Apr;28(4):535–540. doi: 10.1097/00005373-198804000-00022. [DOI] [PubMed] [Google Scholar]