Trauma

Question 1

% involvement of diff cardiac chambers in penetrating trama

Answer 1

RV only 35%
LV only 25%
multi-chamber 30%
RA only rarely

Question 2

survival after stab wounds to the heart

survival after missile injury to the heart

Answer 2

stab 80%

missile 40%

Question 3

blunt cardiac trauma

Answer 3

high energy: rupture of A & V freewall, IVS, tensor apparatus, AV cusps, coronaries into cardiac chamber

mod energy: contusion, esp RV

low energy: Commotio Cordis

Question 4

when is the risk window for commotio cordis

Answer 4

30-15 ms before peak of T

Question 5

most common site of cardiac rupture

Answer 5

RA

can be immediate or delayed

Question 6

IVS rupture with blunt trauma

Answer 6

usually immediate @ time of injury

consider device perc closure; if hemodynamically stable, wait 8-12 weeks before definitive surgical repair

Question 7

AV valve rupture w blunt trauma

Answer 7

usually immediate
TV most commonly involved. may be accomp by RCA rupture into RV. often minimal sx

MV rare. sx frank pulm edema.

Question 8

Late complications of cardiac contusion

Answer 8

• LV aneurysm
• pericarditis
• hemopericardium
• late cardiac tamponade
• late constrictive pericarditis