1
|
Reineke EL, Burkett DE, Drobatz KJ. Left atrial rupture in dogs: 14 cases (1990–2005). J Vet Emerg Crit Care (San Antonio) 2008. [DOI: 10.1111/j.1476-4431.2008.00289.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
2
|
García-Fernández MA, Macchioli RO, Moreno PM, Yangüela MM, Thomas JB, Sendón JL, Lopez de Sa E, Abdou YH. Use of contrast echocardiography in the diagnosis of subacute myocardial rupture after myocardial infarction. J Am Soc Echocardiogr 2001; 14:945-7. [PMID: 11547284 DOI: 10.1067/mje.2001.114135] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Myocardial rupture is an uncommon and catastrophic complication after acute myocardial infarction. It can present in an acute form or in a subacute form, with slower hemorrhage and thrombus formation at the site of rupture. These patients can survive several hours or days before the diagnosis is confirmed and the myocardial ruptured repaired. Two-dimensional Doppler echocardiography is very useful in the diagnosis of this complication, but the number of false-positive diagnoses is high, even in the presence of a large amount of pericardial effusion. In these patients, administration of a contrast agent can be useful to demonstrate active bleeding into the pericardium. We report a case of subacute myocardial rupture for which contrast echocardiography was useful in demonstrating the presence of persistent hemorrhage into the pericardium. To reduce the number of false-positive diagnoses, contrast echocardiography should be considered in patients with possible subacute myocardial rupture.
Collapse
Affiliation(s)
- M A García-Fernández
- Laboratory of Echocardiography, Department of Cardiology, Hospital General Universitario "Gregorio Marañón," Madrid, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Asensio JA, Soto SN, Forno W, Roldan G, Petrone P, Salim A, Rowe V, Demetriades D. Penetrating cardiac injuries: a complex challenge. Injury 2001; 32:533-43. [PMID: 11524085 DOI: 10.1016/s0020-1383(01)00068-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- J A Asensio
- Division of Trauma and Critical Care, Department of Surgery, University of Southern California, LAC+USC Medical Center, 1200 N. State Street, No. 10-750, Los Angeles, CA 90033-4525, USA.
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Abstract
The management of penetrating chest injuries has evolved significantly over the past few years, with an increasing emphasis on less invasive diagnostic and therapeutic modalities. Only 15% of patients need a therapeutic operative procedure. The challenge is to detect and treat these injuries rapidly while maximizing the use of noninvasive examinations and decreasing costs. The areas potentially at risk for injury include the heart, major vessels, thoracoabdomen, neck, spine, and aerodigestive tract. A review of injuries to these areas, including the use of new diagnostic modalities such as echocardiography and computed tomography (CT) scans, are discussed.
Collapse
Affiliation(s)
- S D LeBlang
- Department of Radiology, University of Miami/Jackson Memorial Hospital, Florida 33136, USA.
| | | |
Collapse
|
5
|
Marcì M, Ajello A, Di Francesco M, Floresta AM, Lojacono F, Battaglia A. Echocardiographic Diagnosis of Subacute Ventricular Wall Rupture Complicating Acute Myocardial Infarction. Echocardiography 1999; 16:575-577. [PMID: 11175190 DOI: 10.1111/j.1540-8175.1999.tb00106.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Rupture of ventricular wall is one of the most threatening complications of acute myocardial infarction. As a rule, it is rapidly lethal, and a precise diagnosis is seldom possible. On the contrary, in the so-called subacute ruptures (about one third of all cases), patients can survive for several hours, allowing time for diagnosis and immediate surgical intervention. We report here the case of one patient with subacute cardiac rupture who was diagnosed with echocardiography and successfully treated with pericardiocentesis and surgery.
Collapse
|
6
|
Asensio JA, Stewart BM, Murray J, Fox AH, Falabella A, Gomez H, Ortega A, Fuller CB, Kerstein MD. Penetrating cardiac injuries. Surg Clin North Am 1996; 76:685-724. [PMID: 8782469 DOI: 10.1016/s0039-6109(05)70476-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Penetrating cardiac injuries pose a tremendous challenge to any trauma surgeon. Time, sound judgment, aggressive intervention, and surgical technique are the most important factors contributing to positive outcomes. This article extensively reviews the history, surgical management, and techniques needed to deal with these critical injuries. This year commemorates the one hundredth anniversary of the first successful repair of a cardiac injury.
Collapse
Affiliation(s)
- J A Asensio
- Los Angeles County/University of Southern California Medical Center, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Gutierrez HG, Alshak NS, Kotlewski A. A case of spontaneous innominate artery perforation with pericardial tamponade. CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS 1996; 37:277-80. [PMID: 8974806 DOI: 10.1002/(sici)1097-0304(199603)37:3<277::aid-ccd13>3.0.co;2-f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We describe a case of a spontaneously occurring innominate artery perforation which, rather than resulting in immediate death, developed a subacute course with findings suggestive of an expanding mediastinal mass. The cause of the spontaneous perforation appears to have been a combination of atherosclerosis, infection, and infiltration of the underlying structures with malignancy. This is a unique case of subacute spontaneous perforation of a great vessel.
Collapse
Affiliation(s)
- H G Gutierrez
- Kaiser Permanente Los Angeles Medical Center, California 90027, USA
| | | | | |
Collapse
|
8
|
Plummer D, Dick C, Ruiz E, Clinton J, Brunette D. Emergency department two-dimensional echocardiography in the diagnosis of nontraumatic cardiac rupture. Ann Emerg Med 1994; 23:1333-42. [PMID: 8198310 DOI: 10.1016/s0196-0644(94)70361-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Myocardial rupture is a catastrophic complication of acute myocardial infarction that usually results in sudden death. If diagnosed quickly, patients with myocardial rupture may be salvaged. This report describes the application of emergency department two-dimensional echocardiography in the diagnosis of six cases of myocardial rupture over two years. Each demonstrated a characteristic hemopericardium on limited single-window examination. These included four patients who met institutional guidelines for thrombolytic therapy. Three patients survived surgical repair, with two long-term survivors.
Collapse
Affiliation(s)
- D Plummer
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN
| | | | | | | | | |
Collapse
|
9
|
López-Sendón J, González A, López de Sá E, Coma-Canella I, Roldán I, Domínguez F, Maqueda I, Martín Jadraque L. Diagnosis of subacute ventricular wall rupture after acute myocardial infarction: sensitivity and specificity of clinical, hemodynamic and echocardiographic criteria. J Am Coll Cardiol 1992; 19:1145-53. [PMID: 1564213 DOI: 10.1016/0735-1097(92)90315-e] [Citation(s) in RCA: 225] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
When ventricular free wall rupture after acute myocardial infarction is not followed by sudden death, it is referred to as subacute ventricular rupture. The sensitivity and specificity of clinical, hemodynamic and echocardiographic diagnostic variables obtained at bedside are unknown and were therefore prospectively studied in 1,247 consecutive patients with acute myocardial infarction including 33 patients with subacute ventricular rupture diagnosed at operation (group A) and 1,214 patients without ventricular rupture (at operation, postmortem study or at discharge) (group B). The incidence of syncope, recurrent chest pain, hypotension, electromechanical dissociation, cardiac tamponade, pericardial effusion, high acoustic intrapericardial echoes, right atrial and right ventricular wall compression identified in two-dimensional echocardiograms and hemopericardium demonstrated during pericardiocentesis was higher in group A than in group B (p less than 0.00001). The presence of cardiac tamponade, pericardial effusion greater than 5 mm, high density intrapericardial echoes or right atrial or right ventricular wall compression had a high diagnostic sensitivity (greater than or equal to 70%) and specificity (greater than 90%). The number of false positive diagnoses was always high for each diagnostic variable alone (greater than 20%), but the combination of clinical (hypotension), hemodynamic (cardiac tamponade) and echocardiographic variables allowed a sensitivity of greater than or equal to 65% with a small number of false positive diagnoses (less than 10%) and provided useful information for therapeutic decisions. The diagnosis of subacute ventricular rupture requires a surgical decision. Twenty-five (76%) of the 33 patients with subacute ventricular rupture survived the surgical procedure and 16 (48.5%) are long-term survivors. Thus, subacute ventricular wall rupture is a relatively frequent complication after acute myocardial infarction that can be accurately diagnosed and successfully treated.
Collapse
Affiliation(s)
- J López-Sendón
- Coronary Care Unit, Hospital La Paz, Universidad Autónoma de Madrid, Spain
| | | | | | | | | | | | | | | |
Collapse
|
10
|
|
11
|
Klopfenstein HS. The pathophysiology of pericardial disease--contributions derived from echocardiography/Doppler studies in animal models. Echocardiography 1990; 7:5-9. [PMID: 10149186 DOI: 10.1111/j.1540-8175.1990.tb00342.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The use of acute and chronically prepared animal models of pericardial disease free of the confounding influences of other disease processes have greatly accelerated the development of echocardiographic and Doppler diagnostic methods and have allowed the correlation of these noninvasive findings with hemodynamic abnormalities.
Collapse
Affiliation(s)
- H S Klopfenstein
- Department of Medicine, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, NC 27103
| |
Collapse
|
12
|
Abstract
Ultrasound is a form of imaging that addresses many needs in emergency medicine. It is fast, accurate, safe, noninvasive, and painless. It rapidly diagnoses immediately life-threatening conditions and reduces the number of invasive or delayed diagnostic methods. However, successful imaging requires an understanding of ultrasonic principles. The physical principles of ultrasound imaging with emphasis on its limitations and the benefits of emergency echocardiography are highlighted.
Collapse
Affiliation(s)
- D Plummer
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55415
| |
Collapse
|
13
|
|
14
|
Yousem D, Traill TT, Wheeler PS, Fishman EK. Illustrative cases in pericardial effusion misdetection: correlation of echocardiography and CT. Cardiovasc Intervent Radiol 1987; 10:162-7. [PMID: 3111699 DOI: 10.1007/bf02577994] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Eight equivocal two-dimensional echocardiograms with concurrent CT scans were evaluated to identify potential pitfalls in pericardial effusion detection. By echocardiography, two pleural effusions were felt to be pericardial, two hemopericardiums were interpreted as normal myocardium, three loculated pericardial effusions were not seen or were misinterpreted as other mediastinal collections, and one epicardial lipoma was called a pericardial effusion. When the clinical suspicion for pericardial effusion does not correlate with echocardiographic findings, CT scanning may be the definitive arbiter of pericardial disease.
Collapse
|
15
|
Garcia-Fernandez MA, Lopez-Sendon J, Coma-Canella I, Sotillo J. Echocardiographic detection of circulating blood in normal canine hearts. Am J Cardiol 1985; 56:834-6. [PMID: 4061323 DOI: 10.1016/0002-9149(85)91165-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|