CASE REPORT

Intermittent left bundle branch block (LBBB) as a clinical manifestation of myocardial contusion after blunt chest trauma

V R P Pizzo¹, I Beer², R de Cleva³, B Zilberstein⁴

¹ Department of Clinical Emergencies, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
² Surgical Intensive Care Unit, Digestive Surgery Division, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
³ Gastroenterology Department, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
⁴ Department of Gastroenterology, Digestive Surgery Division, Hospital das Clínicas, University of São Paulo Medical School

Correspondence to:
Correspondence to:
Dr I Beer
Rua Heitor de Souza Pinheiro, 257 ap 63, bl 3, CEP 05750-230, São Paulo, Brazil; drbeer{at}ibest.com.br

Injury to the heart in blunt chest trauma is dependent on a number of factors. Symptoms are often non-specific, and there is no gold standard test for diagnosis. Injuries to small areas of the myocardium may only be identified at autopsy. We report a 38 year old man who sustained a number of injuries in a road traffic accident, and in whom the single clinical or ECG abnormality was a left bundle branch block (LBBB); he had a myocardial injury rated as grade II. The patient was treated for his injuries and later discharged. As this is a difficult diagnosis, algorithms of blunt chest trauma may save time and money by avoiding misleading diagnosis and unnecessary monitoring and admissions.

Keywords: blunt chest trauma; myocardial contusion; bundle branch block

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• Babu, G. G., Wood, A., O'Callaghan, P., Masani, N. D., Bleasdale, R. A. (2009). The complete array of electrocardiogram abnormalities secondary to myocardial contusion in a single case. Europace 11: 1557-1559 [Abstract] [Full Text]