Treatment of heart injuries

The heart is the most important organ in the human body with the function of bringing blood and oxygen to nourish the whole body. The heart is located in the ribcage and is surrounded by the rib cage, sternum and spine, it can be said that the heart is surrounded by an extremely strong bone wall. To create a heart injury, medical experts estimate that there must be a huge force acting on the chest to cause it.
Cardiac trauma can occur in chest trauma, although it occurs very rarely. Injuries can range from very mild to pericardial hematoma, myocardial contusion, rupture of the chambers and structures of the heart muscle, and rupture of the pedicle.
Causes of cardiac injury are usually vascular and sudden trauma to the sternum, in traffic accidents, high falls or work. Mechanism of injury includes sudden deceleration when the heart chambers are filled with blood, causing rupture of weak points on the heart muscle wall and direct trauma pressing on the sternum area causing hematoma, contusion, rupture of heart valves or heart stalk. Most heart injuries are fatal soon after, only minor injuries can be tolerated by the patient for emergency treatment.

Depending on the type of injury, the patient will have different specific symptoms. But in general, most patients with cardiac trauma have symptoms related to circulatory and respiratory syndromes or symptoms. However, each type of heart injury has distinct signs as follows:
Heart concussion: Patients with concussion injuries often have no specific symptoms, most patients have a faster-than-normal heartbeat. often. If left for longer, the injury will develop conduction abnormalities or arrhythmias. Ventricular rupture: These cardiac rupture injuries are often fatal very quickly, however a few small ruptures, especially in the right ventricle, will present with cardiac tamponade. In case of atrial rupture, symptoms of cardiac tamponade will appear gradually. Heart valve tear: This injury will cause a systolic murmur and manifestations of progressive heart failure. Heart septal rupture: The patient has no initial symptoms, but later the patient may develop heart failure. Traumatic Cardiac Arrest: This trauma occurs due to a sudden and rapid force, the pathophysiology is unclear.

Although the above signs partly help the doctor diagnose the patient's trauma, to most accurately determine the damage caused by heart injury, the doctor will assign the patient to perform a number of tests such as: x-ray, electrocardiogram, ultrasound, pericardiocentesis. However, because of the dangerous nature of trauma, especially heart failure, patients need to be quickly diagnosed for timely treatment.

Depending on each case of heart injury, the doctor will recommend the most appropriate treatment for the patient.
Traumatic heart rupture : Surgical treatment is imperative in this emergency with open surgery with midsternal longitudinal opening. Principles of surgical treatment are as follows:
Drain the pleura before endotracheal anesthesia if there is hemothorax or pneumothorax Prepare the extracorporeal circulatory system and all means of hemostasis before pericardiotomy in case of blood loss. Open the pericardium, remove thrombus and blood, and probe for lesions. If the injury is simple, it is treated like a heart wound, broken heart injury at the atrial appendages, the atrial appendage must be tied to stop the bleeding. If the damage is complicated, temporarily stop the bleeding, install extracorporeal circulation to probe carefully and treat the injury. Clean the pericardial cavity, drain and close the sternum

The majority of broken heart injuries, with prompt emergency and surgery, the survival rate is up to 80% for a single-chamber rupture.
Myocardial concussion: Patients with cardiac contusion are usually prescribed medical treatment and bed rest, good ventilation to ensure oxygen, and adequate volume compensation. If the patient has signs of heart failure or arrhythmia, treatment must be given immediately. Use drugs that increase myocardial contractility only when prescribed by a specialist. Heart valve injury: Heart valve injuries are mainly medical treatment against heart failure. Valve repair or valve replacement surgery is indicated in severe cases of valve regurgitation and is performed 1 month after the date of injury. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology system. The hospital provides comprehensive, professional medical examination, consultation and treatment services, with a civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.