title: The frequency of type 2 second-degree and third-degree atrioventricular block induced by blunt chest trauma in the emergency department: A multicenter study.
abstract: BACKGROUND
  Conduction disturbances including type 2 second-degree atrioventricular block (Mobitz II) and third-degree atrioventricular block following blunt chest trauma are probably rare. Moreover, the pathophysiological mechanisms responsible for this rare dysrhythmia following trauma are not well understood yet. In this study, it was aimed to identify the frequency of this dysrhythmia associated with trauma.
  
  
  METHODS
  Two hundred and fifty-three consecutive Mobitz II block and third-degree atrioventricular block patients admitted to the Emergency Department of Internal Medicine between January 2012 and March 2013 were evaluated. Only four patients with Mobitz II block and third-degree atrioventricular block associated with trauma were enrolled into the present study. The level of atrioventricular block was defined according to electrocardiographic characteristics.
  
  
  RESULTS
  Only four (mean age: 40.2±19.7 years, two male) of 253 patients were associated with trauma. All patients had normal coronary arteries in coronary angiography or multislice computed tomography. Permanent pacemaker was performed in two patients with third-degree atrioventricular block. None of the patients had coronary artery disease or hypertension.
  
  
  CONCLUSIONS
  Rare clinical cases in the literature confirm that blunt chest trauma can cause conduction defects, which are usually transient. However, patients with blunt chest trauma must need an electrocardiographic evaluation for atrioventricular block upon admission and in the follow-up period.
authors.affiliation: Department of Internal Medicine, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey. maliastarcioglu@gmail.com.
authors.forename: Banu
authors.initials: B
authors.lastname: Şahin Yıldız
authors.affiliation: Department of Cardiology, Dumlupınar University Evliya Çelebi Training and Research Hospital, Kütahya, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Astarcıoğlu
authors.affiliation: Department of Internal Medicine, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey.
authors.forename: Nazire
authors.initials: N
authors.lastname: Başkurt Aladağ
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Hasdemir
authors.affiliation: Department of Cardiology, Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Şahin
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yıldız
mesh_terms: D000328:Adult; D000368:Aged; D054537:Atrioventricular Block / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012720:Severity of Illness Index; D013898:Thoracic Injuries / Q000150:complications*; D014421:Turkey / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000150:complications*; D055815:Young Adult