title: A case of commotio cordis caused by steering wheel injury.
abstract: We report a rare case of commotio cordis caused by traffic injury. The patient was a 60-year-old female driver who suffered severe steering wheel impact to the chest during a head-on collision in which her car overturned. She had no history of cardiac disease. Emergency medical services arrived at the scene within 12 minutes of the accident. Evidence of ventricular fibrillation led the paramedics to carry out immediate defibrillation with an automated external defibrillator. Restoration of spontaneous circulation was confirmed within 2 minutes, along with establishment of sinus rhythm and normal wave form on electrocardiography. The patient was transported to our hospital in an emergency helicopter. General examination revealed chest bruising, and computed tomography of the chest showed pulmonary contusions; there was no other evidence of critical injury. We performed endotracheal intubation, as the patient had consciousness disturbance, and then initiated hypothermic therapy in the intensive care unit. Meanwhile, the hemodynamics remained stable, and there was no recurrence of arrhythmia. On day 15, the patient's consciousness improved, and she was able to communicate. Two months later, she was transported to another hospital for rehabilitation.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Chiba, Japan. moonsong@nms.ac.jp
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kutsukata
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Mashiko
authors.forename: Hisashi
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hara
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Koami
mesh_terms: D000063:Accidents, Traffic; D056104:Commotio Cordis / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018986:Motor Vehicles; D014693:Ventricular Fibrillation / Q000150:complications