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KMID : 0356919960300030353
Korean Journal of Anesthesiology
1996 Volume.30 No. 3 p.353 ~ p.357
Cardiac Injury Diagnosed with Echocardiogram in the Patient of Blunt Chest Trauma



Abstract
Blunt trauma of the chest and abdomen frequently result in cardiac injury. We experienced a 47 year-old male patient of myocardial contusion with aortic insufficiency after blunt chest trauma. On the secondd day after admission, the patient
developed
sudden hypoxemia and wide pulse pressure. A pulmonary arterial catheter was inserted and initial cardiac output and pulmonary capillary wedge pressure was 3.56L/min/m* and 32mmHg, rspectively. There was akinesia of the anterior septum, anterior
wall,
inferior wall and inferior septum with aortic regurgitation(I/IV), and the ejection fraction was 25% on echocardiogram. Myocardial contusion with valvular injury was suspected. Dobutamine infusion was started and after five days the pulmonary
capillary
wedge pressure was decreased to 14 mmHg. The ejection fraction was increased to 69% in spite of decreasing dobutamine but aortic regurgitation(II/VI) remained. Therefore echocardiogram and pulmonary artery catheterization will be helpful to
diagnose
suspected cardiac contusion and for better outcome. (Korean J Anesthesiol 1996; 30: 353~357)
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