Batchelor Timothy J, Imperato Nicholas S, Wheel Kathryn L, Rennie Alexander J, Roth Kevin R
Lehigh Valley Health Network, Department of Emergency and Hospital Medicine / USF Morsani College of Medicine, Cedar Crest Boulevard & I-78, Allentown, PA, 18103, USA.
Lehigh Valley Health Network, Department of Surgery, Division of Trauma and Acute Care Surgery / USF Morsani College of Medicine, Schoenersville Road, Bethlehem, PA 18017, USA.
Radiol Case Rep. 2022 Sep 28;17(12):4546-4549. doi: 10.1016/j.radcr.2022.09.021. eCollection 2022 Dec.
Atrial septal defects (ASD) caused by traumatic events, specifically blunt cardiac trauma, are considered an infrequent occurrence, yet their true prevalence has been difficult to ascertain. The general lack of knowledge is likely due to the pathology being severely understudied. We present the case of a 21-year-old male who was diagnosed with ASD following a motor vehicle accident. Initial assessment utilizing the point-of-care ultrasound (POCUS) technique - focused assessment with sonography for trauma (FAST) was found to be negative for free intraperitoneal or pericardial fluid. Subsequent computed tomography displayed multiple injuries but agreed with the FAST exam findings of no fluid within the abdomen or pericardium. Later in the patient's care a dedicated POCUS transthoracic echocardiogram was performed which identified right sided heart dilatation. The patient was managed in the intensive care unit (ICU) for an extensive period but recovered sufficiently to be discharged. The plan was to repair the ASD on a non-emergent basis. This case highlights the importance and diagnostic utility of bedside POCUS.
Emergency Medicine.
由创伤性事件,特别是钝性心脏创伤引起的房间隔缺损(ASD)被认为较为罕见,但其真实患病率难以确定。普遍缺乏了解可能是由于对该病理研究严重不足。我们报告一例21岁男性病例,其在机动车事故后被诊断为房间隔缺损。最初使用床旁超声(POCUS)技术——创伤重点超声评估(FAST)进行评估,发现腹腔内或心包内无游离液体。随后的计算机断层扫描显示多处损伤,但与FAST检查结果一致,即腹部或心包内无液体。在患者后续治疗中,进行了专门的床旁经胸超声心动图检查,发现右心扩张。患者在重症监护病房(ICU)接受了长时间治疗,但恢复良好得以出院。计划在非紧急情况下修复房间隔缺损。该病例突出了床旁POCUS的重要性和诊断效用。
急诊医学。