Left ventricular and papillary muscle rupture following blunt chest trauma

Ischaemic papillary muscle rupture without significant coronary artery lesion

Papillary muscle rupture is a rare but life-threatening complication of myocardial infarction (MI). Here, we describe a case of papillary muscle rupture caused by a microscopic MI. A 76-year-old woman was referred to our institution, where she developed cardiac arrest upon admission. Severe mitral regurgitation was noted without significant coronary artery lesions. Emergency surgery was performed, and posteromedial papillary muscle rupture was observed. Postoperatively, cardiac magnetic resonance imaging revealed a microscopic MI of the posteromedial papillary muscle.

Trauma Associated with Cardiac Conduction Abnormalities: Population-Based Perspective, Mechanism and Review of Literature

OBJECTIVES

Various cardiac conduction abnormalities have been described as being a result of trauma in many case reports. The aim of this research was to look at the association between trauma (thoracic and cardiac) and conduction abnormalities in a large hospitalized population.

METHODS

Cases diagnosed with trauma and various cardiac conduction disorders were identified based on ICD-9-CM discharge diagnoses from 986 acute general hospitals across 33 states in 2001.

RESULTS

Independent of potential confounding factors, discharge for blunt cardiac injury (BCI) was associated with a threefold increased risk for cardiac conduction abnormalities (95% confidence interval 2.45-4.51) during hospitalization in 2001. Both BCI and thoracic trauma had a significant association with right bundle branch block (RBBB) in this study (OR 6.04; 95% confidence interval (CI) 3.77-9.67 and OR 1.75; 95% CI 1.38-2.23 respectively).

CONCLUSIONS

The results of this study demonstrate the impact of trauma on cardiac conduction abnormalities. This study represents an attempt to consider a mechanism of a complex traumatic cardiac event from a population-based perspective, and may improve the prognosis for patients diagnosed with cardiac or thoracic injuries.

A Rupture of Both Atrioventricular Valves After Blunt Chest Trauma: The Usefulness of Transesophageal Echocardiography for a Life-Saving Diagnosis

Survival after the rupture of the both mitral and tricuspid valves in blunt thoracic trauma is uncommon and requires prompt diagnosis and treatment. We present a case in which transesophageal echocardiography performed in the operating room by the anesthesiologist identified the etiology of hemodynamic instability and facilitated successful emergency replacement of both valves.

Obstructive intramural coronary amyloidosis and papillary muscle rupture

Mitral papillary muscle rupture is usually caused by ischaemia as a complication of myocardial infarction. In a 76 year old patient with no significant disease or major cardiovascular risk factors, papillary muscle rupture was caused by obstructive intramural coronary amyloidosis, an unusual cause.

Traumatic papillary muscle rupture

Papillary muscle rupture caused by blunt chest trauma is a relatively rare cause of mitral incompetence. To date only 25 cases of surgically corrected posttraumatic mitral regurgitation have been reported, of which only eight resulted from rupture of the anterolateral papillary muscle.

Cardiac trauma. Diagnosis, management, and current therapy

In cardiac trauma the two main mechanisms of injury are blunt and penetrating trauma. Common cardiac effects of trauma include myocardial rupture, contusion, laceration, pericardial insult, coronary injury, valvular damage, arrhythmias, and conduction abnormalities. Hemodynamic instability can develop rapidly and pose marked risk to patient survival. An adequate level of clinical awareness and timely use of diagnostic techniques such as echocardiography, aortography, and cardiac angiography are essential for rapid identification of cardiac trauma. Once the diagnosis is made, prompt surgical intervention is often the key to survival.

Lung injury with pleuropericardial rupture successfully treated by video-assisted thoracoscopy: case report

We present a case of lung injury with pleuropericardial rupture resulting from blunt chest trauma. A conclusive diagnosis and successful treatment was achieved by video-assisted thoracoscopy. The value of diagnostic modalities and the role of video-assisted thoracoscopy in the management of these challenging patients are discussed.