Complete heart block following a blow on the chest by a soccer ball: a rare manifestation of commotio cordis [Case Report]
Commotio cordis is a rare type of blunt cardiac injury in which low impact chest trauma causes sudden cardiac arrest, usually occurs from being struck by a projectile during sports. The most common arrhythmia during commotio cordis is ventricular fibrillation, although complete heart block and an idioventricular rhythm have also been reported. We describe a case of a young patient who presented with a persistent third-degree atrioventricular block and a left bundle branch block, following blunt chest trauma, as a result of blow by soccer ball and subsequently needed a permanent pacemaker.
Echocardiographic characteristics in patients > or =100 years of age
The centenarian population is increasing, and patients > or =100 years old are encountered more frequently in clinical practice. Cardiovascular disease is the most common cause of death in this subset of patients. We report the echocardiographic characteristics of 63 hospitalized centenarians. Patients ranged in age from 100 to 112 years and were admitted to the hospital for a variety of diagnoses. The mean left ventricular end-diastolic dimension was 3.9 +/- 0.7 cm (2.8 to 5.8), the mean left ventricular end-systolic dimension was 1.8 +/- 0.7 cm (0.8 to 3.5), the mean ventricular septal thickness was 1.2 +/- 0.25 cm (0.8 to 1.9), the mean left ventricular posterior wall thickness was 1.1 +/- 0.14 cm (0.8 to 1.6), the mean left ventricular ejection fraction was 84% +/- 11% (49% to 97%), the mean aortic root diameter at the level of the sinuses was 3.3 +/- 0.4 cm (2.1 to 4.1), the mean left atrial dimension was 4.5 +/- 0.7 cm (3.1 to 7), the mean right ventricular end-diastolic dimension was 3.4 +/- 0.6 cm (2.0 to 4.8), and the mean pulmonary artery systolic pressure was 37 +/- 14 mm Hg. Moderate or severe valvular lesions were common, including aortic stenosis (27%), aortic regurgitation (17%), mitral regurgitation (22%), and tricuspid regurgitation (28%). In conclusion, centenarian hearts have important differences from younger hearts, including more hypertrophied left ventricle, higher ejection fraction, higher pulmonary artery systolic pressure, and more prevalent significant valvular heart disease.