title: Subacute tension hemopneumothorax with novel electrocardiogram findings.
abstract: This case report describes a patient with a subacute right-sided tension hemopneumothorax following an occult stab. The patient's electrocardiogram (ECG), performed as part of a standardized triage process, demonstrated significant abnormalities that misguided initial resuscitation, but resolved following evacuation of the tension hemopneumothorax. Tension pneumothorax is typically regarded as an immediately life-threatening condition that requires emergent management with needle or tube thoracostomy. However, we believe that subacute tension pneumothorax may be a rarely observed clinical phenomenon and may lead to unique ECG findings. We believe that the ECG changes we observed provided an early clue to the eventual diagnosis of a subacute tension pneumothorax and have not been previously described in this setting. .
authors.affiliation: Drexel University College of Medicine, Department of Emergency Medicine, Philadelphia, PA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Saks
authors.forename: Sharon
authors.initials: S
authors.lastname: Griswold-Theodorson
authors.forename: Furkan
authors.initials: F
authors.lastname: Shinaishin
authors.forename: Dawn
authors.initials: D
authors.lastname: Demangone
references.citation: Chest. 1984 Jul;86(1):143-5
references.pmid: 6734277
references.citation: Chest. 1999 Jul;116(1):257-60
references.pmid: 10424539
references.citation: Emerg Med J. 2001 Jul;18(4):319-20
references.pmid: 11435384
references.citation: Acta Cardiol. 1988;43(6):653-61
references.pmid: 3266413
references.citation: Emerg Med J. 2002 Sep;19(5):470-1
references.pmid: 12205015
references.citation: Acta Cardiol. 1979;34(2):85-93
references.pmid: 313650
references.citation: Anesthesiology. 1996 Nov;85(5):1200-2
references.pmid: 8916841
references.citation: Am Rev Tuberc. 1951 Jul;64(1):50-63
references.pmid: 14838288
references.citation: Chest. 2000 May;117(5):1527
references.pmid: 10807857
references.citation: Postgrad Med. 1980 Oct;68(4):221-3, 226
references.pmid: 7422601
references.citation: Chest. 1973 Jan;63(1):127-8
references.pmid: 4684101
references.citation: J Emerg Med. 2009 Apr;36(3):242-5
references.pmid: 17976810
references.citation: Ann Intern Med. 1974 Mar;80(3):375-9
references.pmid: 4816180
references.citation: Chest. 1976 Oct;70(4):535-7
references.pmid: 975956
references.citation: Am Heart J. 1982 Feb;103(2):303-5
references.pmid: 7055065
references.citation: Am J Emerg Med. 1998 Mar;16(2):163-5
references.pmid: 9517694
references.citation: Am Heart J. 1948 May;35(5):800-12
references.pmid: 18912336
references.citation: Anesthesiology. 1973 Nov;39(5):525-33
references.pmid: 4746057
references.citation: Am J Obstet Gynecol. 1999 Jun;180(6 Pt 1):1468-71
references.pmid: 10368491
references.citation: J Electrocardiol. 1997 Apr;30(2):109-11
references.pmid: 9141605
references.citation: Chest. 1999 Jun;115(6):1742-4
references.pmid: 10378578
references.citation: Emerg Med J. 2005 Jan;22(1):8-16
references.pmid: 15611534
references.citation: Dis Chest. 1949 Jun;15(6):709-19
references.pmid: 18139479
references.citation: South Med J. 1998 Jul;91(7):677-80
references.pmid: 9671844
references.citation: J Accid Emerg Med. 2000 May;17(3):222-3
references.pmid: 10819392