TY - JOUR PY - 2017// TI - Blunt cardiac injury due to trauma associated with snowboarding: a case report JO - Journal of medical case reports A1 - Yamaji, Fuminori A1 - Okada, Hideshi A1 - Nakajima, Yasuhiro A1 - Suzuki, Kodai A1 - Yoshida, Takahiro A1 - Mizuno, Yosuke A1 - Okamoto, Haruka A1 - Kitagawa, Yuichiro A1 - Tanaka, Taku A1 - Nakano, Shiho A1 - Nachi, Sho A1 - Doi, Tomoaki A1 - Kumada, Keisuke A1 - Yoshida, Shozo A1 - Ishida, Narihiro A1 - Shimabukuro, Katsuya A1 - Ushikoshi, Hiroaki A1 - Toyoda, Izumi A1 - Doi, Kiyoshi A1 - Ogura, Shinji SP - e80 EP - e80 VL - 11 IS - 1 N2 - BACKGROUND: Cardiac trauma is associated with a much higher mortality rate than injuries to other organ systems, even though cardiac trauma is identified in less than 10% of all trauma admissions. Here we report blunt trauma of the left atrium due to snowboarding trauma. CASE PRESENTATION: A 45-year-old Asian man collided with a tree while he was snowboarding and drinking. He lost consciousness temporarily. An air ambulance was requested and he was transported to an advanced critical care center. On arrival, a pericardial effusion was detected by a focused assessment with sonography for trauma. His presenting electrocardiogram revealed normal sinus rhythm and complete right bundle branch block. Laboratory findings included a white blood cell count of 13.5 × 10(3)/μl, serum creatine kinase level of 459 IU/l, and creatine kinase-myocardial band level of 185 IU/l. Enhanced computed tomography showed a large pericardial effusion and bleeding from his left adrenal gland. There were no pelvic fractures. A diagnosis of cardiac tamponade due to blunt cardiac injury and left adrenal injury due to blunt trauma was made. Subsequently, emergency thoracic surgery and transcatheter arterial embolization of his left adrenal artery were performed simultaneously. A laceration of the left atrial appendage in the lateral wall of his left ventricle was detected intraoperatively and repaired. His postoperative course progressed favorably, although a pericardial effusion was still detected on chest computed tomography on hospital day 35. His electrocardiogram showed normal sinus rhythm and the complete right bundle branch block pattern changed to a narrow QRS wave pattern. He was discharged on hospital day 40.

CONCLUSIONS: The present case report illustrates two points: (1) severe injuries resulted from snowboarding, and (2) complete right bundle branch block was caused by blunt cardiac injury. The present report showed blunt trauma of the left atrium with complete right bundle branch block as an electrocardiogram change due to snowboarding trauma. To detect cardiac trauma in snowboarding accidents, an examination of an electrocardiogram is required in all patients who might have a bruised chest.

Language: en

LA - en SN - 1752-1947 UR - http://dx.doi.org/10.1186/s13256-017-1242-2 ID - ref1 ER -