Key result
Among 33 patients who sustained a severe blow to the chest or crushing injury of the thorax, 8 had abnormal electrocardiographic tracings of definite significance within 48 hours.
Why the study?
What are the electrocardiographic changes in patients following severe chest trauma?
Observational (n=33)
No
What are the electrocardiographic changes in patients following severe chest trauma?
Severe chest trauma can cause early electrocardiographic abnormalities, particularly in young patients without underlying degenerative heart disease.
Answers are grounded in this paper and cite their sources.
May prompt early ECG evaluation after severe chest trauma; leaves open incidence, prognosis, and management implications.
Many electrocardiograms have been recorded in cases of trauma of the heart.Beck (1935 and 1940) has studied the problem in the surgical wards and in animal experiments.Kissane (1937 and 1940) has published clinical and experimental records, and in Warburg's analysis of cases (1938 and 1940) there are his own tracings and those of other workers.Anderson (1940) published a case, with full clinical details and convincing electrocardiographic proof of myocardial injury.Zuckerman (1942) and Kessler (1941) record experiments.From this hospital (Barber, 1938 and 1940) there are clinical notes of case histories suggesting heart trauma dating back to 1910; and there is evidence from accident autopsies (Barber and Osborn, 1941).Both animal experiments and clinical records suggest that the electrocardiogram should be taken quite soon after the injury, because abnormalities may be in evidence only for a short time.This paper gives an account of a series of electrocardiograms from patients, irrespective of their symptoms, who came to hospital as the direct result of a severe blow over the front of the chest, or some crushing injury of the thorax.Most of the examinations were made within a few hours of the accident and all within 48 hours; the patients being seen in the casualty department, the radio- logical department, or a surgical ward.The total number examined was thirty-three, in whom there were eight abnormal tracings of definite but varying significance, and two that were inconclusive.The accidents were all from traffic or industry; not one of them was the result of enemy action.They were selected, as opportunity arose, on the basis of having sustained a reasonably severe blow or injury.All those showing an abnormal tracing were with one exception below 45 years in age, and they were active people free from degenerative processes.The youngest, aged 17 years, who developed heart block from a crushing injury of the thorax, is a good illustration of the fact that in the young and elastic chest the heart may be injured without fractures of bone.There was rather a high proportion of seriously injured in the series, but that is to be expected, if one seeks material coming to hospital soon after 83 on July 16,
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H. W. Barber (1942) conducted an observational in Severe blow to the chest or crushing injury of the thorax (n=33). Severe blow to the chest or crushing injury of the thorax was evaluated on Abnormal electrocardiographic tracings. Among 33 patients who sustained a severe blow to the chest or crushing injury of the thorax, 8 had abnormal electrocardiographic tracings of definite significance within 48 hours.
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