Blunt Cardiac Trauma Complicated by Ventricular Tachycardia, AV Block and Right Bundle Branch Block

Case Report: Blunt or non-penetrating cardiac trauma is a relatively common body injury in industrialized communities. We report a young man who sustained a heavy non-penetrating chest trauma and developed ventricular tachycardia, atrioventricular block, and right bundle block with ST elevation in the right precordial lead. He was treated successfully and was discharged home. The true incidence of blunt chest injury (myocardial contusion) after chest trauma is not known. Severe myocardial injury can occur with little evidence of external chest trauma. Blunt cardiac trauma may be mild with only epicardial ecchymosis. More severe contusion causes muscle injury and infarction,1-2 and the injuries that are likely to occur include contusion and valve injuries, especially in the aortic valve, which is the most frequently involved valve in blunt cardiac trauma. Injury of the mitral valve is less common and involves the rupture of the papillary muscle or the chordal apparatus. Injury to the tricuspid valve is second to the aortic valve.3 Atrial or ventricular septal defect or frank cardiac rupture, not least in the right ventricle, can also occur.