? blunt myocardial injury

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None of the above. In a "stable patient" the more you know about him the better your game plan. After full vascular clinical exam and cxr,
Follow up with echo to look Ao root, chambers, effusion, contractility and EF at that fast rate.
For now I will not do anything fancy except rate control and telemetry with cardiology consult.
Good luck
Juan
CharityOne NO
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-----Original Message-----
From: joe.nemeth at mcgill.ca

Date: Tue, 01 Apr 2008 12:35:39 
To:trauma-list at trauma.org
Subject: ? blunt myocardial injury



15 y.o male, prev. healthy...
Kicked in the chest 8 hours prior to presentation...
Feeling "funny" since...
Besides the pulse (180-220/min), all other VS normal...
Exam non-contributory...
ECG attached...

-maybe one prior episode of "palpitations" in the past

Treatment:

1) one of : CCB/BB/Dig
2) electrical cardioversion
3) Amio
4) since pt. stable, wait for peds cardiology to arrive approx 2-3 
hours...("first, do no harm")
5) none of the above

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