suv
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e?
injury to sternum?
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| wywywy2006
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Yes, E
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| young_doc
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Myocardial contusion.
There is heart-congestion, leading to worsening PO2 and raise in PCWP after giving fluids...
Now since there's arrhythmias but no ST elevation --> Myocardial contusion. (also associated with sternal fractures)
(In aortic rupture, there shouldn't be a decrease in PO2 or an increase in PCWP after giving 1L of fluids)
Edited by young_doc on 07/18/07 - 05:34 PM
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| wywywy2006
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Why it is not due to pulmonary contusion.
The patient has multiple injuries. I dout myocardial contusion can respond to 1 l fuid like this way. Only pulmonary contusion can respond so poorly to fluid resuscitation.
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| young_doc
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pulm contusion --> associated with rib injuries (not sternal). Also you wouldn't have arrhythmias or increased PCWP in pulmonary contusion.
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| ssrpk
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agree with myocardial contusion...what should be the treatment?
antiarryhtmics, probably liudocaine or amiodarone
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| cirus
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myocard contusion..
rupure aorta----> LOW pcwp ( hypovolemic shock)
just always put in mind that high PCWP---> cardiac failure
low PCWP----> hypovol, septic shock
normal PCWP---> ARDS
normal = 8-14
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| khorshid
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myocardial contusion
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| radonc
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I agree with myocardial contusion. I think the treatment is expectant. Most cases resolve by themselves, but such patients need monitoring with continuous ECG for arrhythmias. The most common arrhythmias are ventricular ectopics. Antiarrhythmics are not usually given, because they are not without adverse effects.
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| Tuscani
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yep myocardial contusion!
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