MEDI7212 Lecture Notes - Lecture 64: Vertebra, Thoracic Cavity, Foley Catheter
Document Summary
Intracardiac missiles - remove (hemodynamic instability, embolise or exposed) vs leave in place (embedded in myocardium, pericardium or coronary artery); long term effects of retained missile are bacterial endocarditis, thrombosis, embolization and cardiac neurosis. Iatrogenic cardiac injury - central line placement, thoracentesis, chest tube placement, pericardiocentesis, percutaneous coronary catheterization, valvuloplasty, and electrophysiologic lab procedures. Pericardial: deceleration injury -> distal end of heart to free swing like pendulum -> pericardial tear exposing heart -> heart herniation or abdominal contents herniates upwards. Heart: valves, papillary muscle, chordae tendinae, septum, 10% blunt cardiac injury results in cardiac valve injury (aortic > mitral > tricuspid) Coronary vessels o rare complication of blunt cardiac injury: most common artery involved is lad. Pericardial inflammation syndrome: delayed hypersensitivity reaction to presence of damaged myocardium in pericardial cavity, chest pain, fever, pleural or pericardial effusions that occur 2-4 weeks post-trauma/ post-surgery, rx nsaids.
