Blunt cardiac injury Closed

Blunt outlined closed injury cardiac chest injuries about 10% ~ 25%. However, as often their lack of vigilance, to a lesser extent, little performance, or other injury cover where missed. Some people think that it may account for the incidence of blunt chest trauma of over 50%. Clinically, the heart often closed injury to several factors combined caused. Most of the accidents caused injuries. Cause pathogenesis mechanism of the injury : ① direct role : certain intensity of the one-way direct role in the strength of heart before District injury, or accompanied sternum and rib fractures of the stabbing. ② indirect role : the abdomen suffered a sudden squeeze, the sudden influx of a large number of blood the heart and great vessels, cavity pressure surge, rupture caused injury. ③ slowdown role : high-speed movement of the human body by the sudden deceleration, inertia, the heart can be kept in chest or spine. or does not mean a slowdown of the heart so happened reversed, caused injury. ④ compression : Heart have been squeezed hard in the sternum and spine injuries between. ⑤ knock role : Words direct role in the damage caused by heart. Clinical manifestations of cardiac trauma can be cited with varying degrees and types of injury, including : ① pericardial injury, contusion or broken. Pericardial rupture only rarely see, the general merger in other parts of cardiac injury. ② myocardial contusion, from small films or endometrial epicardial blood stasis under which grouper (myocardial concussion), myocardial layers until all the torn and bleeding, edema and necrosis. ③ cardiac rupture : Most of the injuries occurred immediately, or bleeding caused cardiac tamponade; very few of the injuries after a few days or a few weeks after myocardial contusion area as a softening of necrosis and delayed rupture occurred. in relatively stable condition after serious chest pain and sudden cardiac tamponade. ④ traumatic heart septal defect : multiple ventricular septal rupture, similar to the mechanism of ventricular rupture. in the end-diastolic and systolic ventricular filling early, and when the valve is closed by the sudden violence of cardiac pressure caused by the sudden rise interval tear , or broken myocardial contusion necrosis caused by the softening of delayed perforation. ⑤ valve injury : aortic valve up, tearing or perforation, followed by the mitral valve, often tendons or papillary muscle rupture. Original heart disease, such as aortic valve two or Marfan syndrome, and more vulnerable to injury. ⑥ coronary artery injury : most of the left anterior descending artery laceration. ⑦ traumatic aneurysm : myocardial contusion or necrosis caused by coronary artery occlusion true aneurysm. Closed cardiac injuries often associated injuries, such as rib and sternum fractures and blood, such as pneumothorax. Simple inspection of myocardial contusion few positive signs, ECG diagnosis of larger value, performance of the ST segment elevation and T wave inversion scar. Most of tachycardia, before the contraction and paroxysmal atrial fibrillation. Serum creatine kinase isoenzyme CPK-MB and lactate dehydrogenase isoenzymes LDH1 and bands have diagnostic value. Treatment of cardiac rupture and coronary artery rupture patients often rapid death, only a handful of fortunate sent to the hospital to be diagnosed. Rare traumatic rupture and ventricular septal valve damage, if not for any other serious injuries and deaths combined. Patients have the opportunity to further diagnosed sent to the hospital after cardiac surgery under cardiopulmonary bypass surgery. Myocardial contusion treatment is symptomatic treatment, control and prevention arrhythmia heart failure, and to observe whether aneurysm occurred.