A 42-year-old woman involved in a head on collision arrived at the Emergency Room talking coherently, with the following vital signs. Her examination revealed equal air entry bilat... A 42-year-old woman involved in a head on collision arrived at the Emergency Room talking coherently, with the following vital signs. Her examination revealed equal air entry bilaterally with ecchymosis on her anterior chest wall, distended neck veins and her abdomen is soft and lax. Blood pressure 90/60 mmHg, Heart rate 130/min, Respiratory rate 18/min Which of the following is the most likely diagnosis? B. Cardiac contusion C. Massive hemothorax Beck's Triad
Understand the Problem
The question describes a 42-year-old woman involved in a head-on collision, presenting with specific vital signs and physical examination findings. It asks to identify the most likely diagnosis from the given options, considering the patient's symptoms such as hypotension, tachycardia, chest wall ecchymosis, distended neck veins, and normal respiratory findings. Beck's Triad will need to be considered, looking for signs of cardiac tamponade.
Answer
Cardiac contusion is the most likely diagnosis, given the symptoms and mechanism of injury.
The most likely diagnosis is cardiac contusion. The combination of hypotension, elevated heart rate, distended neck veins, and chest wall ecchymosis (likely from the impact) points towards a problem with the heart's ability to pump effectively, which can occur in cardiac contusion. This presentation is also consistent with Beck's Triad.
Answer for screen readers
The most likely diagnosis is cardiac contusion. The combination of hypotension, elevated heart rate, distended neck veins, and chest wall ecchymosis (likely from the impact) points towards a problem with the heart's ability to pump effectively, which can occur in cardiac contusion. This presentation is also consistent with Beck's Triad.
More Information
Cardiac contusion involves bruising of the heart muscle, which can impair its ability to pump blood effectively and lead to symptoms similar to those described in the question.
Tips
A common mistake is to confuse the symptoms of cardiac contusion with other conditions like massive hemothorax or tension pneumothorax. Focus on the specific combination of symptoms, especially the presence of Beck's Triad (hypotension, distended neck veins, and muffled heart sounds, though the latter isn't explicitly mentioned but can be present).
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