Traumatic Cardiac Injury Following Sternal Fracture : a Case Report and Literature Review

胸骨骨折雖不必然導致心臟破損，但心臟損傷卻是胸骨骨折主要的併發症之一，尤其對於胸部鈍傷合併心包膜填塞之病人，臨床醫師更應提高警覺，注意心血管受損的可能，以期早期診斷，早期手術治療，以提昇存活率。我們報告一位38歲女性病人因車禍受傷被送到本院急診室診治，到院時病人的血壓為90/50mmHg，二小時後病人血壓掉到60/30mmHg，病人的胸部X光及心電圖檢查並未有異常發現，但胸部電腦斷層發現胸骨骨折合併心包膜填塞，診斷為胸部鈍傷致胸骨骨折合併心臟破損，因此緊急行正中胸骨切開術，縫補右心房破裂，病人經術後三個月追蹤，癒後良好。

關鍵字

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並列摘要

Myocardial injury used to be thought as one of the major complications associated with sternal fracture even though recent studies on injuries associated with fracture of sternum are contrary to this belief. Many authors now believe the presence of sternal fracture is no longer indicative of occult injuries to the underlying structure such as the heart. However, clinicians should still maintain a high index of suspicion for the presence cardiac tamponade in cases presented as blunt chest trauma as early diagnosis and surgical intervention is vital to the patient's survival. Presented is a case of a 38-year-old female patient transferred to our hospital after being injured in a motor vehicle accident. On arrival her blood pressure (BP) was 90/50 mmHg but it then dropped to 60/30 mmHg two hours later. Although her chest roentgenography and electrocardiography (ECG) did not reveal any significant findings, the two-dimensional echocardiography was performed and revealed a moderate amount of pericardia I effusion. The chest was performed and revealed a moderate amount of pericardia I effusion. The chest computerized tomography (CT) scan later revealed sternal fracture and cardiac tamponade. A diagnosis of cardiac rupture resulting from sternal fracture following blunt chest trauma was made. Under midline sternotomy, her right atrial rupture was repaired. The patient was reported to be doing well during a three months, post-operative follow-up.

並列關鍵字

cardiac tamponade ； right atrial rupture ； sternal fracture

國際替代計量

Traumatic Cardiac Injury Following Sternal Fracture : a Case Report and Literature Review

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