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Intermittent left bundle branch block (LBBB) as a clinical manifestation of myocardial contusion after blunt chest trauma
  1. V R P Pizzo1,
  2. I Beer2,
  3. R de Cleva3,
  4. B Zilberstein4
  1. 1Department of Clinical Emergencies, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
  2. 2Surgical Intensive Care Unit, Digestive Surgery Division, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
  3. 3Gastroenterology Department, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
  4. 4Department of Gastroenterology, Digestive Surgery Division, Hospital das Clínicas, University of São Paulo Medical School
  1. Correspondence to:
 Dr I Beer
 Rua Heitor de Souza Pinheiro, 257 ap 63, bl 3, CEP 05750-230, São Paulo, Brazil; drbeeribest.com.br

Abstract

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.

  • blunt chest trauma
  • myocardial contusion
  • bundle branch block

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Footnotes

  • Competing interests: none declared