PMID- 34332603
OWN - NLM
STAT- MEDLINE
DCOM- 20210819
LR  - 20210819
IS  - 1757-7241 (Electronic)
IS  - 1757-7241 (Linking)
VI  - 29
IP  - 1
DP  - 2021 Jul 31
TI  - The way to a man's heart is through his stomach: a case of myocardial infarction 
      mimic and pseudo-tamponade in a polytrauma patient.
PG  - 106
LID - 10.1186/s13049-021-00911-4 [doi]
LID - 106
AB  - BACKGROUND: There exists a therapeutic conflict between haemorrhage control and 
      prevention of thromboembolic events following polytrauma and complications are 
      not uncommon. Such opposing therapies can result in unexpected pathophysiology 
      and there is a real risk of misdiagnosis resulting in harm. This case presents a 
      previously unreported complication of prevention and management of 
      thromboembolism- STEMI (ST elevation myocardial infarction) and tamponade mimic 
      secondary to retroperitoneal haematoma. CASE PRESENTATION: We present a 
      50-year-old male polytrauma patient who following treatment for presumed 
      pulmonary embolus demonstrated classical clinical findings of myocardial 
      infarction and pericardial tamponade secondary to a retroperitoneal haematoma. 
      This is an event not previously reported in the literature. The risk of adverse 
      outcome by management along the standard lines of STEMI (ST elevation myocardial 
      infarction) was averted through awareness for alternative aetiology via a 
      multi-team approach which resulted in percutaneous drainage of the haematoma and 
      complete resolution of symptoms. CONCLUSIONS: This manuscript highlights the 
      therapeutic conflict between haemorrhage control and prevention of thromboembolic 
      events in critically injured, the importance of high index of suspicion in this 
      patient cohort and the benefits of multidisciplinary decision making in the 
      complex patient through a not previously published pathophysiologic phenomenon.
CI  - (c) 2021. The Author(s).
FAU - Brun, Mathew
AU  - Brun M
AD  - Adult Intensive Care, Unit Gold Coast University Hospital, 1 Hospital Blvd, 
      Southport, Queensland, 4215, Australia. Mathew.brun@health.qld.gov.au.
FAU - Brun, Shane
AU  - Brun S
AD  - Medical Education Unit Gold Coast University Hospital, 1 Hospital Blvd, 
      Southport, Queensland, 4215, Australia.
FAU - Pearson, David
AU  - Pearson D
AD  - Adult Intensive Care, Unit Gold Coast University Hospital, 1 Hospital Blvd, 
      Southport, Queensland, 4215, Australia.
FAU - Wullschleger, Martin
AU  - Wullschleger M
AD  - Trauma Service Royal Brisbane and Women's Hospital, Herston, Queensland, 4029, 
      Australia.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210731
PL  - England
TA  - Scand J Trauma Resusc Emerg Med
JT  - Scandinavian journal of trauma, resuscitation and emergency medicine
JID - 101477511
SB  - IM
MH  - Electrocardiography
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Multiple Trauma/complications
MH  - *Myocardial Infarction/diagnosis
MH  - *Percutaneous Coronary Intervention
MH  - *ST Elevation Myocardial Infarction/diagnosis
MH  - Stomach
MH  - Treatment Outcome
PMC - PMC8325207
OTO - NOTNLM
OT  - Anticoagulation
OT  - Haematoma
OT  - Mimic
OT  - Multi-trauma
OT  - Polytrauma
OT  - Pseudotamponade
OT  - STEMI
OT  - Tamponade
OT  - Thrombolysis
OT  - Trauma
COIS- The authors declare that they have no competing interests.
EDAT- 2021/08/02 06:00
MHDA- 2021/08/20 06:00
PMCR- 2021/07/31
CRDT- 2021/08/01 20:27
PHST- 2021/06/23 00:00 [received]
PHST- 2021/07/02 00:00 [accepted]
PHST- 2021/08/01 20:27 [entrez]
PHST- 2021/08/02 06:00 [pubmed]
PHST- 2021/08/20 06:00 [medline]
PHST- 2021/07/31 00:00 [pmc-release]
AID - 10.1186/s13049-021-00911-4 [pii]
AID - 911 [pii]
AID - 10.1186/s13049-021-00911-4 [doi]
PST - epublish
SO  - Scand J Trauma Resusc Emerg Med. 2021 Jul 31;29(1):106. doi: 
      10.1186/s13049-021-00911-4.