title: Intermittent left bundle branch block (LBBB) as a clinical manifestation of myocardial contusion after blunt chest trauma.
abstract: Injury to the heart in blunt chest trauma is dependent on a number of factors. Symptoms are often non-specific, and there is no gold standard test for diagnosis. Injuries to small areas of the myocardium may only be identified at autopsy. We report a 38 year old man who sustained a number of injuries in a road traffic accident, and in whom the single clinical or ECG abnormality was a left bundle branch block (LBBB); he had a myocardial injury rated as grade II. The patient was treated for his injuries and later discharged. As this is a difficult diagnosis, algorithms of blunt chest trauma may save time and money by avoiding misleading diagnosis and unnecessary monitoring and admissions.
authors.affiliation: Department of Clinical Emergencies, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: V R P
authors.initials: VR
authors.lastname: Pizzo
authors.forename: I
authors.initials: I
authors.lastname: Beer
authors.forename: R
authors.initials: R
authors.lastname: de Cleva
authors.forename: B
authors.initials: B
authors.lastname: Zilberstein
mesh_terms: D000328:Adult; D002037:Bundle-Branch Block / Q000209:etiology* / Q000628:therapy; D003288:Contusions / Q000150:complications* / Q000628:therapy; D004322:Drainage / Q000379:methods; D004562:Electrocardiography; D004630:Emergencies; D006335:Heart Injuries / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D016896:Treatment Outcome