? blunt myocardial injury

[joe.nemeth at mcgill.ca]

Sorry Folks, I thought I had already replied...

-The ECG shows a WC tachyarrythmia...basically A. Fib with aberrant 
conduction....

-?due to the chest thump?..vs. coincidental discovery of WPW...

-no matter..kid sedated..cardioverted...with classic post-conversion 
delta waves signifying the kid had a, as yet undiagnosed, WPW...


great case...

jn





Quoting Ian Seppelt <seppeli at wahs.nsw.gov.au>:

> So what was the answer, Joe?
>
>>>> joe.nemeth at mcgill.ca 04/02/08 3:35 am >>>
>
> 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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