Wilke A, Kruse T, Hesse H, Bittinger A, Moosdorf R, Maisch B
Zentrum für Innere Medizin, Abteilung Kardiologie, Klinikum der Philipps-Universität, Marburg, Germany.
J Trauma. 1997 Aug;43(2):360-1. doi: 10.1097/00005373-199708000-00027.
In many cases blunt chest trauma involves cardiac lesions, such as pericardial effusion, aneurysma dissecans, or valvular rupture. Early diagnosis with routine transthoracic and/or transesophageal echocardiography is essential to prevent a fatal outcome. In the case reported, a previously healthy 68-year-old woman fell 7 meters from the roof of a barn and sustained blunt injury to the chest as well as fractures of the face. Physical examination revealed a systolic murmur at the cardiac apex, and chest x-ray film showed a severe pulmonary edema. Transesophageal echocardiography demonstrated a ruptured anterolateral papillary muscle with fourth degree mitral insufficiency. An immediate mitral valve replacement was necessary.
在许多情况下，钝性胸部创伤会累及心脏病变，如心包积液、夹层动脉瘤或瓣膜破裂。通过常规经胸和/或经食管超声心动图进行早期诊断对于预防致命后果至关重要。在报告的病例中，一名68岁既往健康的女性从谷仓屋顶跌落7米，胸部受到钝性损伤以及面部骨折。体格检查发现心尖部有收缩期杂音，胸部X光片显示严重肺水肿。经食管超声心动图显示前外侧乳头肌破裂伴四度二尖瓣关闭不全。立即进行二尖瓣置换术是必要的。
