Transient complete right bundle branch block due to lung contusion: case report

Year 2024, , 38 - 41, 28.06.2024

Nalan Kozaci , İsmail Erkan Aydın , Durmus Ali Ersahin , Yavuz Yüksel

https://doi.org/10.33706/jemcr.1410026

Abstract

Introduction: Right bundle branch block (RBBB) may occur in lung diseases and cardiovascular diseases.
Case Report: A 25-year-old male patient was admitted to emergency department after a motorcycle accident. Contusion was detected in bilateral lungs, and pneumothorax with laceration were detected in the right lung. ECG revealed 103 bpm, right axis deviation, and complete RBBB. ECG revealed 83 bpm, complete RBBB continued at the 6th hour after tube thoracostomy, and high sensitive TnI was normal. Chest X-ray was normal on the 4th day of hospitalization, and ECG revealed 74 bpm, normal sinus rhythm.
Conclusion: In thoracic trauma, ECG changes may develop as a result of lung contusion. ECG findings improve as the lung contusion heals.

Keywords

Lung contusion, Right bundle branch block, RBBB, Thorax trauma

Ethical Statement

Since it is a retrospective case report and does not contain patient personal information, informed consent form and ethics committee approval were waived.

References

• 1. Ruhela M, Khandelwal G, Gupta S, Bansal A. Acute right bundle branch block due to pneumothorax. J Family Med Prim Care. 2018;7(5):1126. https://doi.org/10.4103/jfmpc.jfmpc_222_18
• 2. Biondi NL, Bhandari M, Bhyan P. Transient Right Bundle Branch Block Resulting From a Blunt Cardiac Injury During a Motor Vehicle Accident. Cureus. 2020 Sep 18; https://doi.org/10.7759/cureus.10534
• 3. Klin B, Gueta I, Bibi H, Baram S, Abu-Kishk I. Electrocardiographic changes in young patients with spontaneous pneumothorax. Medicine. 2021 Jul 30;100(30):e26793. https://doi.org/10.1097/MD.0000000000026793
• 4. Minotti B, Brenner R, May Desbiolles L, Osterwalder J, Schoch OD, Ammann P. Electrocardiographic alterations by pneumothorax: a case-control study with review of the literature. Swiss Med Wkly. 2021 Aug 3;151(3132):w30041. https://doi.org/10.4414/SMW.2021.w30041
• 5. Edgecombe L, Sigmon DF, Galuska MA, Angus LD. Thoracic Trauma. 2023. PMID: 30521264
• 6. Choudhary S, Pasrija D, Mendez MD. Pulmonary Contusion. 2023. PMID: 32644340
• 7. Kozaci N, Avcı M, Ararat E, Pinarbasili T, Ozkaya M, Etli I, et al. Comparison of ultrasonography and computed tomography in the determination of traumatic thoracic injuries. Am J Emerg Med. 2019 May;37(5):864–8. https://doi.org/10.1016/j.ajem.2018.08.002
• 8. Decavèle M, Gault N, Gauss T, Pease S, Moyer JD, Paugam-Burtz C, et al. Cardiac troponin I as an early prognosis biomarker after trauma: a retrospective cohort study. Br J Anaesth. 2018 Jun;120(6):1158–64. https://doi.org/10.1016/j.bja.2018.03.010
• 9. Van Lieshout EMM, Verhofstad MHJ, Van Silfhout DJT, Dubois EA. Diagnostic approach for myocardial contusion: a retrospective evaluation of patient data and review of the literature. European Journal of Trauma and Emergency Surgery. 2021 Aug 25;47(4):1259–72. https://doi.org/10.1007/s00068-020-01305-4
• 10. Ho Ryu J, Ran Yeom S, Woo Jeong J, Ki Min M, Real Park M, In Kim Y, et al. Correlation Between Pulmonary Contusion and Myocardial Contusion in Patients with Multiple Injuries. Journal of Trauma and Injury. 2011;24(1):31–6.
• 11. Sağlam Gürmen E. Attention: Cardiac Contusion. Turkish Journal of Trauma and Emergency Surgery. 2021; https://doi.org/10.14744/tjtes.2021.11290
• 12. Kopeć G. Electrocardiography in pulmonary hypertension. Pol Arch Intern Med. 2019 Aug 29;129(7–8):440–1. https://doi.org/10.20452/pamw.14952
• 13. Kozaci N, Ay MO, Beydilli I, Kartal ZA, Celik A, Sasmaz I, et al. Right-sided electrocardiogram usage in acute pulmonary embolism. Am J Emerg Med. 2016 Aug;34(8):1437–41. https://doi.org/10.1016/j.ajem.2016.04.025