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Heart trauma: Myocardial involvement following a non-penetrating injury to the chest

Heart trauma: Myocardial involvement following a non-penetrating injury to the chest

Ann Internal Med 27(1): 126-134

The case of a 34 yr. old airplane pilot is discussed who suffered a severe crushing but non-penetrating injury to the chest during a forced landing. The case was of interest because 1) a non-penetrating trauma was capable of causing substantial though transient myocardial injury; 2) myocardial involvement was not readily apparent before the 3d hospital day, and the peak of the ecg. changes occurred during the 2d wk. following the accident; 3) the ecg. changes were confined to the final portion of the T wave; and 4) these were seen only in precor-dial leads V1] to V3. The resulting lesion was judged to be superficial because of the absence of demonstrable S-T displacement. It was thought to involve the epicardial layers because the pattern obtained was similar in many respects to the changes observed in certain stages of pericarditis. The location of the lesion made its detection possible only by the use of multiple precordial leads. These, in addition, allowed some insight into the progression, extension, and involution of the process.

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Accession: 024771949

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