Late cardiac arrhythmias after blunt chest trauma.
OBJECTIVE
Case reports of two patients who developed fatal cardiac arrhythmias several days after blunt chest trauma.


METHODS
Case reports.


METHODS
Surgical intensive care unit of a university hospital.


METHODS
A 23-year-old man and a 9-year-old girl with blunt chest trauma and multiple further injuries following car crashes were transferred to our institution. Although ECG on admission was normal, both patients developed fatal cardiac arrhythmias after 6 and 4 days, respectively. In both patients, post-mortem analysis confirmed myocardial contusion without coronary artery lesions. Histological findings included severe interstitial oedema, haemorrhages and infiltration of lymphocytes and neutrophils, fresh myocardial necrosis and fatty degeneration.


CONCLUSIONS
Blunt chest trauma with myocardial contusion may lead to fatal cardiac arrhythmias even after several days, particularly when other severe injuries are present. Thus, a normal ECG on admission and absence of cardiac arrhythmias during the first 24 h of intensive care treatment do not necessarily exclude the occurrence of life-threatening arrhythmias in the further course.
Sakka
S G
SG
Department of Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller-University of Jena, Germany. samir.sakka@med.uni-jena.de
Huettemann
E
E
Giebe
W
W
Reinhart
K
K
D000063:Accidents, Traffic; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002648:Child; D003288:Contusions / Q000150:complications* / Q000175:diagnosis; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006335:Heart Injuries / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D009104:Multiple Trauma; D009206:Myocardium / Q000473:pathology; D013898:Thoracic Injuries / Q000150:complications* / Q000175:diagnosis; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis