heart damage
Introduction
Introduction to heart damage Cardiac injuries often occur in dangerous areas of heart injury (from the upper boundary from the clavicle, the lower boundary to the rib arch, and the outside is the nipple line), which is subject to open or closed injury. Therefore, it is often divided into penetrating lesions and non-penetrating lesions. Most of the heart penetrating injuries are caused by the penetration of sharps such as bullets, shrapnel and sharp knives, and a few can be caused by violent inward displacement of the sternum or rib fracture. In addition, there are cardiovascular surgery or invasive catheterization or angiography. The resulting iatrogenic injury. The heart parts of the injury are the right ventricle, the left ventricle, the right atrium, the left atrium, and the like. Mainly manifested as pericardial tamponade and / or hemorrhagic shock, both have a focus. basic knowledge The proportion of sickness: 0.01%-0.08% Susceptible people: no special people Mode of infection: non-infectious Complications: arrhythmia
Cause
Cause of heart injury
Most of the heart damage is caused by a car accident at high speed. The driver is squeezed between the body and the steering wheel, accounting for 5% of the cause of the car accident in the United States. Sharp injuries are caused by knife stabs and bullets. Heart contusion can also be caused by high-altitude falling or chest wall before and after being strongly squeezed by objects. It is more common in earthquakes or construction site collapses. The heart is suddenly squeezed by the acceleration of the sternum and spine. The pressure in each heart chamber, especially in the left ventricle, suddenly rises. Free ventricular wall, atrial wall, and ventricular septum, heart valve structure, etc. can be ruptured or perforated. Coronary artery spasm can also occur by chance. Mild blunt trauma mainly leads to different degrees of myocardial contusion, more common in the right ventricle.
Prevention
Heart injury prevention
After the heart-penetrating trauma occurs, as long as the patient is properly treated and treated in time, about 80% of the patients can be saved. The effect of shrapnel injury on the battlefield is relatively poor, and it is related to the scope of injury, general conditions at admission, and other organ damages. The overall treatment rate is about 40%.
The right atrium is less prone to pressure and easier to expose, so the prognosis is best; the left ventricular rupture has little survival; the left atrium and right ventricular rupture have a therapeutic effect between the two. Because the right heart chamber pressure is lower than the left side, the bleeding rate can be slowed or stopped after the formation of cardiac tamponade, and patients often get further treatment. Cardiac rupture caused by blunt heart injury is generally good when injured, especially in young patients. Unless the rupture is very large, most patients are repaired by timely surgery and the effect is good.
Complication
Heart injury complications Complications arrhythmia
Arrhythmia, heart rupture.
Symptom
Symptoms of heart damage Common symptoms Pericardial rupture, dyspnea, palpitations, pericardial hemorrhage
There is no obvious symptom in the light, and the pain in the precordial area may occur in the heavier person, which may be accompanied by palpitations and difficulty in breathing. I can hear the pericardial friction sound.
Examine
Cardiac injury examination
The electrocardiogram can have ST-segment elevation, T-wave low-level or inverted, and often shows arrhythmia such as tachycardia, atrial or ventricular premature beats. Phosphocreatine kinase-isozyme (CPK-MB) and lactate dehydrogenase (LDH1, and LDH2) values were significantly elevated. Two-dimensional echocardiography can show changes in cardiac structure and function, combined with ECG changes and elevated serum enzymes, when a diagnosis of cardiac contusion can be diagnosed.
Diagnosis
Diagnosis of heart injury diagnosis
Diagnosis is generally not difficult. Any penetrating injury in the chest heart danger zone, as well as penetrating the neck, upper abdomen, chest, posterior chest wall or mediastinum, should be alert to the possibility of a damaged heart. In the above-mentioned areas, especially in the anterior region of the heart, there are wounds, and in the short-term, severe hypotension and severe shock can almost diagnose the diagnosis of heart damage.
The electrocardiogram can have ST-segment elevation, T-wave low-level or inverted, and often shows arrhythmia such as tachycardia, atrial or ventricular premature beats. Phosphocreatine kinase-isozyme (CPK-MB) and lactate dehydrogenase (LDH1, and LDH2) values were significantly elevated. Two-dimensional echocardiography can show changes in cardiac structure and function, combined with ECG changes and elevated serum enzymes, when a diagnosis of cardiac contusion can be diagnosed.
