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Updated: Mar 23 2025

Cardiac Conditions

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  • Summary
  • Overview
  • Syncope
  • Hypertrophic Cardiomyopathy
  • Coronary Artery Disease
  • Commotio Cordis
    • Overview
      • it results in cardiac ventricular fibrillation and is universally fatal unless immediate defibrillation is performed
      • caused by direct impact during ventricular repolarization
      • a rare but catastrophic condition that is caused by blunt chest trauma
    • Epidemiology
      • incidence
        • less than 30 cases per year
      • demographics
        • age
          • average age is 15 years old
            • most common in children and adolescents due to high number of athletes
        • sex
          • male:female ratio is 20 to 1
      • risk factors
        • contact sports
        • younger age
    • Etiology
      • pathophysiology
        • mechanism of injury
          • traumatic blow to the anterior chest during ventricular repolarization leading to ventricular depolarization resulting in ventricular fibrillation
      • pathoanatomy
        • anterior chest wall blow occurring during the upstroke of the T-wave with enough energy (>50 joules) leading to myocardial cell membrane stretch
          • the upstroke of the T-wave is 1% of the cardiac cycle
          • smaller balls increase risk due to decreased surface area of impact
          • higher energy impacts are more likely to cause structural damage and not isolated ventricular fibrillation
        • results in activation of ion channels through mechanical-electrical coupling resulting in aberrant depolarization resulting in ventricular fibrillation
    • Presentation
      • history
        • patient experiences a sudden blow to the chest, typically during an athletic event
      • symptoms
        • loss of consciousness
      • physical exam
        • pulselessness
        • unconsciousness
        • death
    • Studies
      • electrocardiogram
        • will show ventricular fibrillation
    • Diagnosis
      • diagnosis is made by witnessed blow to the chest followed by collapse with electrocardiogram showing ventricular fibrillation
    • Treatment
      • CPR vs.cardiac defibrillation
        • the best method of treatment is cardiac defibrillation
      • return to sport
        • no restrictions from returning to sport
        • athletes should take precautions against future blows to the chest
    • Prevention
      • chest protectors in baseball and hockey have not yielded the protective results desired
    • Prognosis
      • poor prognosis with a mortality rate of 59%
      • improved mortality rate with early defibrillation
  • Long QT Syndrome
  • Sudden Cardiac Death
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Question
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In scope icon L 1 B
QID 3668 (Type "3668" in App Search)
A 22-year-old male undergoes retrograde intramedullary nailing for the injury seen in Figure A. Which of the following would place ...
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Knee & Sports | Cardiac Conditions
  • Knee & Sports
  • - Cardiac Conditions
16:13 min
2/25/2020
231 plays
4.5
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