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20. Stumpfe Herzverletzungen

Blunt cardiac trauma

  • B. Wissenschaftliches Programm
  • I. Hauptthemen mit Diskussion B. Herzverletzungen und Mediastinaltumoren a) Herzverletzungen
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Langenbecks Archiv für Chirurgie Aims and scope Submit manuscript

Summary

Cardiac injuries were present in 16% of our patients suffering from blunt chest trauma. 25% of these cases had no concomitant rib fractures. Sonography is extremely important for evaluation. In myocardial contusion the electrocardiogram reveals mainly disturbances in repolarisation (66 out of 108 patients) and rhythm disturbances (59 patients). A ratio of CK-MB isoenzyme/total CK of over 8 % is highly suggestive of myocardial injury. Continuous monitoring in ICU is mandatory. Prognosis is mainly based on additional injuries. Heart wall rupture and luxation of the heart require operative treatment. Lesions of the aortic valves are the most frequent valve injuries.

Zusammenfassung

16% der Patienten mit stumpfem Thoraxtrauma erlitten eine Herzverletzung, 25 % von ihnen ohne gleichzeitige Rippenfrakturen. In der Akutsituation ist die Sonographie unerläßlich geworden. Bei der Herzkontusion finden sich im EKG vor allem Repolarisationsstörungen (66 von 108 Patienten) und Rhythmusstörungen (59 Patienten). Ein Anteil CK-MB über 8 % der Total-CK scheint beweisend. Die Überwachung auf einer Intensivstation ist unerläßlich, wobei Begleitverletzungen die Prognose bestimmen. Herzwandrupturen und eine Herzluxation bedingen ein sofortiges operatives Vorgehen. Von den Herzklappen sind am häufigsten die Aortenklappen verletzt.

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Authors and Affiliations

  1. Klinik für Unfallchirugie und Klinik für Herz-Gefäßchirurgie, Universitätsspital Zürich, Rämistraße 100, CH-8091, Zürich

    W. Glinz & M. Turina

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  1. W. Glinz
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  2. M. Turina
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Glinz, W., Turina, M. 20. Stumpfe Herzverletzungen. Langenbecks Arch Chiv 369, 129–138 (1986). https://doi.org/10.1007/BF01274337

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