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Echocardiography and trauma

Rei-Yeuh Chang, Chien-Chang Chen, Wei-Pang Hsu, Pei-Ching Hsiao, Han-Lin Tsai, Ping-Gune Hsiao, Jiann-Der Wu, How-Ran Guo
BACKGROUND: Avulsion of the aortic valve commissure as a cause of acute aortic valve regurgitation is mostly due to trauma, infective endocarditis, or ascending aortic dissection. Nontraumatic avulsion of the aortic valve commissure is very rare. We reviewed the literature and analyzed potential risk factors of nontraumatic avulsion. CASE PRESENTATION: An 80-year-old male with hypertension was seen in the emergency department with acute onset dyspnea. Echocardiogram revealed left ventricular hypertrophy with adequate systolic function, prolapse of the noncoronary cusp, and incomplete coaptation of the right coronary and noncoronary cusps with severe aortic valve regurgitation...
October 2016: Medicine (Baltimore)
J Heiberg, L S Hansen, K Wemmelund, A H Sørensen, C Ilkjaer, E Cloete, D Nolte, F Roodt, R Dyer, J Swanevelder, E Sloth
PURPOSE: Our institution has recently implemented a point-of-care (POC) ultrasound training program, consisting of an e-learning course and systematic practical hands-on training. The aim of this prospective study was to evaluate the learning outcome of this curriculum. MATERIALS AND METHODS: 16 medical students with no previous ultrasound experience comprised the study group. The program covered a combination of 4 well-described point-of-care (POC) ultrasound protocols (focus assessed transthoracic echocardiography, focused assessment with sonography in trauma, lung ultrasound, and dynamic needle tip positioning for ultrasound-guided vascular access) and it consisted of an e-learning course followed by 4 h of practical hands-on training...
November 2015: Ultrasound Int Open
Salma Charfeddine, Dorra Abid, Faten Triki, Souad Mallek, Leila Abid, Samir Kammoun, Ayman Dammak, Imed Frikha
We reported a rare case of non-penetrating chest trauma-induced fistula from the right sinus of Valsalva to the right heart chambers. The ruptured sinus of Valsalva aneurysm was diagnosed preoperatively and operated on successfully. The rarity of this case highlights the need for a precise preoperative diagnosis, the role of transthoracic echocardiography, and the importance of a prompt surgical management.
October 2016: Journal of the Saudi Heart Association
Chris W Piercecchi, Julio C Vasquez, Stephen J Kaplan, Jordan Hoffman, John D Puskas, Jacob DeLaRosa
We present a rare late complication after inferior vena cava filter (IVC) placement. A 52-year-old woman with an IVC presented with sudden onset of chest pain. Cardiac catheterisation and echocardiography revealed an embolised IVC filter strut penetrating the right ventricle. Endovascular retrieval was considered but deemed unsafe due to proximity to the right coronary artery and concern for migration to pulmonary circulation. Urgent removal of the strut was performed via sternotomy. The postoperative course was uneventful...
September 5, 2016: Heart, Lung & Circulation
Micah R Whitson, Paul H Mayo
Point-of-care ultrasonography (POCUS) is a useful imaging technique for the emergency medicine (EM) physician. Because of its growing use in EM, this article will summarize the historical development, the scope of practice, and some evidence supporting the current applications of POCUS in the adult emergency department. Bedside ultrasonography in the emergency department shares clinical applications with critical care ultrasonography, including goal-directed echocardiography, echocardiography during cardiac arrest, thoracic ultrasonography, evaluation for deep vein thrombosis and pulmonary embolism, screening abdominal ultrasonography, ultrasonography in trauma, and guidance of procedures with ultrasonography...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
Katarina Ivana Tudor, Damir Petravić, Anđela Jukić, Zlatko Juratovac
OBJECTIVE: To present a patient with a sudden onset ocular tilt reaction (OTR) and review recent knowledge and evolving insights of the underlying pathophysiological mechanisms of skew deviation and OTR. METHODS: A middle-aged hypertensive man who had previously suffered stroke with good recovery presented with sudden-onset double vision, slurred speech, ataxia, and a head tilt. Romberg test was positive. The patient denied having disturbances of visual acuity, eye pain, or recent trauma...
July 29, 2016: Seminars in Ophthalmology
Ahmet Can Topcu, Ufuk Ciloglu, Ahmet Bolukcu, Sabri Dagsali
Traumatic aortic rupture is rupture of all or part of the aortic wall, mostly resulting from blunt trauma to the chest. The most common site of rupture is the aortic isthmus. Traumatic rupture of the ascending aorta is rare. A 62-year-old man with a family history of ascending aortic aneurysm was referred to our hospital after a motor vehicle accident. He had symptoms of cardiogenic shock. A contrast-enhanced computed tomographic scan revealed rupture of the proximal ascending aorta and an ascending aortic aneurysm with a diameter of 55 mm at the level of the sinuses of Valsalva...
August 2016: Annals of Thoracic Surgery
Waldemar Elikowski, Bartosz Kudliński, Małgorzata Małek-Elikowska, Joanna Foremska-Iciek, A Baszko, Paweł Skrzywanek
Takotsubo cardiomyopathy (TC) is characterized as an acute, reversible left ventricular dysfunction which may be triggered by mental or physical stress. In the case of a 32-year-old woman severe heart failure was observed after a traffic accident with blunt chest trauma. ECG showed ST changes mimicking acute myocardial infarction; although, echocardiography revealed a profile of left ventricular contractile disturbances typical of TC, with ejection fraction reduced to 20%. Additionally, repeated echocardiography showed transient left ventricular wall thickness, suggestive of myocardial edema...
June 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Vishwas Malik, Ajay Kumar Jha, Poonam Malhotra Kapoor
Continuously growing patient's demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS). Patient's demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation...
July 2016: Annals of Cardiac Anaesthesia
Mahmoud Mazen, Ahmed Abdelgawad, Ahmed El-Shemy, Mona Ramadan, Hani Al-Batrek, Ousama Mahdi, Mahmoud M Ramadan
BACKGROUND Cardiac tumors are quite rare, and differential diagnosis of them is challenging. CASE REPORT A young lady with a history of palpitations, dyspnea, and fatigue was proven by transthoracic echocardiography and cardiac magnetic resonance imaging to have a mobile left ventricular mass with rounded contour attached to the mid-part of the interventricular septum. The mass was approached via a posterior inter-atrial approach to avoid left ventriculotomy and provide adequate exposure to completely excise the tumor and control its pedicle with minimal cardiac trauma...
2016: American Journal of Case Reports
Matthew J Griffee, Andrew Singleton, Joshua M Zimmerman, David E Morgan, Raminder Nirula
To evaluate the effect of rescue transesophageal echocardiography (TEE) on the management of trauma patients, we reviewed imaging and charts of unstable trauma patients at a level I trauma center. Critical rescue TEE findings included acute right ventricular failure, stress cardiomyopathy, type B aortic dissection, mediastinal air, and dynamic left ventricular outflow tract obstruction. Left ventricular filling was classified as low (underfilled) in 57% of all cases. Rescue TEE revealed a variety of new diagnoses and led to a change in resuscitation strategy about half of the time...
June 15, 2016: A & A Case Reports
Sumi Westhofen, Lenard Conradi, Tobias Deuse, Christian Detter, Eik Vettorazzi, Hendrik Treede, Hermann Reichenspurner
OBJECTIVES: Advances in video-assistance lead to an increase in minimal access mitral valve surgery (MAMVS) with decreased incision size yet maintaining the same quality of surgery. Further reduction in surgical trauma and at the same time improved visual guidance can be achieved by a non-rib-spreading fully 3D endoscopic technique (NRS-3D). We compared patients who underwent MAMVS either through an NRS fully 3D endoscopic or rib-spreading (RS) access in a retrospective matched-pair analysis...
June 3, 2016: European Journal of Cardio-thoracic Surgery
Tsuyoshi Fujimiya, Yoichi Sato, Mitsuaki Sadahiro
Rupture of sinus of Valsalva is a rare entity that occurs as a result of penetrating cardiac trauma or as a complication of infective endocarditis, aneurysm of the sinus of Valsalva, or aortic dissection. A 41-year-old man was admitted to our hospital with continual fever and general fatigue. Streptococcus mutans was detected from his blood cultures. Echocardiography showed perimembranous type ventricular septal defect and right Valsalva- right ventricle fistula. We performed surgery after 4 weeks'administration of antibiotics...
June 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Christian T Braun, Meret E Ricklin, Aristomenis K Exadaktylos
We present a rare case of severe ischaemic papillary muscle rupture in a 67-year-old male patient who was admitted to the Emergency Department of the University Hospital Bern, Switzerland, in November 2013 with acute chest pain. On admission, the patient's blood pressure was 60/40 mm/Hg, his pulse was 110 beats per minute and his respiratory rate was 20 breaths per minute. An electrocardiogram was normal and focused assessment with sonography in trauma was negative. Transthoracic echocardiography showed possible thickening of the mitral valve leaflet with no indications of severe mitral insufficiency or wall motion abnormalities...
May 2016: Sultan Qaboos University Medical Journal
Alexander Levitov, Heidi L Frankel, Michael Blaivas, Andrew W Kirkpatrick, Erik Su, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Matthew McLaughlin, Paul E Marik, Mahmoud Elbarbary
OBJECTIVE: To establish evidence-based guidelines for the use of bedside cardiac ultrasound, echocardiography, in the ICU and equivalent care sites. METHODS: Grading of Recommendations, Assessment, Development and Evaluation system was used to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and to determine the "strength" of recommendations as either strong (strength class 1) or conditional/weak (strength class 2), thus generating six "grades" of recommendations (1A-1B-1C-2A-2B-2C)...
June 2016: Critical Care Medicine
Ahmed Hasanin, Amr Kamal, Shereen Amin, Dina Zakaria, Riham El Sayed, Kareem Mahmoud, Ahmed Mukhtar
BACKGROUND: Although cardiac injury has been reported in patients with various neurological conditions, few data report cardiac injury in patients with traumatic brain injury (TBI). The aim of this work is to report the incidence of cardiac injury in patients with TBI and its impact on patient outcome. METHODS: A prospective observational study was conducted on a cohort of 50 patients with severe TBI. Only patients with isolated severe TBI defined as Glascow coma scale (GCS) < 8 were included in the study...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Paul J Devlin, Carl L Backer, Osama Eltayeb, Michael C Mongé, Amanda L Hauck, John M Costello
BACKGROUND: We evaluated the outcomes of patients undergoing surgical repair of partial atrioventricular septal defect (AVSD) and analyzed the effect of age on outcome. METHODS: In this single-center retrospective study, we included all children who underwent repair of partial AVSD between 1990 and 2014. We divided the patients into 4 age quartiles (first quartile: 0-0.75 years, n = 22; second quartile: 0.75-1.5 years, n = 21; third quartile: 1.5-3.75 years, n = 22; and fourth quartile: >3...
July 2016: Annals of Thoracic Surgery
Rodrigo de Lima E Souza, Bruno Tavares Apgaua, João Daniel Milhomens, Francisco Tadeu Motta Albuquerque, Luiz Antônio Carneiro, Márcio Henrique Mendes, Tiago Carvalho Garcia, Clerisson Paiva, Felipe Ladeia, Deiler Célio Jeunon
BACKGROUND AND OBJECTIVES: Fat embolism syndrome may occur in patients suffering from multiple trauma (long bone fractures) or plastic surgery (liposuction), compromising the circulatory, respiratory and/or central nervous systems. This report shows the evolution of severe fat embolism syndrome after liposuction and fat grafting. CASE REPORT: SSS, 42 years old, ASA 1, no risk factors for thrombosis, candidate for abdominal liposuction and breast implant prosthesis...
May 2016: Brazilian Journal of Anesthesiology
Joel Kian Boon Lim, Jan Hau Lee, Yee Hui Mok, Ching Kit Chen, Yee Jim Loh
Intramyocardial hematoma is a rare condition and is an incomplete form of myocardial rupture, which may occur after myocardial infarction, cardiac surgery, trauma, percutaneous coronary intervention, or spontaneously. We describe a case of a 16-year-old girl with intramyocardial hematoma mimicking an intracavitary thrombus following repair of Ebstein anomaly. The intramyocardial hematoma was incorrectly diagnosed on echocardiography as a right ventricular thrombus, and the true nature of the lesion was only realized during repeat surgical intervention for severe tricuspid regurgitation...
April 20, 2016: World Journal for Pediatric & Congenital Heart Surgery
Sabino Scolletta, Federico Franchi, Stefano Romagnoli, Rossella Carlà, Abele Donati, Lea P Fabbri, Francesco Forfori, José M Alonso-Iñigo, Silvia Laviola, Valerio Mangani, Giulia Maj, Giampaolo Martinelli, Lucia Mirabella, Andrea Morelli, Paolo Persona, Didier Payen
OBJECTIVES: Echocardiography and pulse contour methods allow, respectively, noninvasive and less invasive cardiac output estimation. The aim of the present study was to compare Doppler echocardiography with the pulse contour method MostCare for cardiac output estimation in a large and nonselected critically ill population. DESIGN: A prospective multicenter observational comparison study. SETTING: The study was conducted in 15 European medicosurgical ICUs...
July 2016: Critical Care Medicine
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