From the Guidelines
After a motor vehicle accident (MVA), patients with suspected cardiac injury should be immediately evaluated for symptoms such as chest pain, hemodynamic instability, and electrocardiographic (ECG) abnormalities, as early diagnosis and management are crucial to improve outcomes. According to the ACR Appropriateness Criteria for blunt chest trauma-suspected cardiac injury 1, common symptoms of cardiac injury after an MVA include:
- Chest pain
- Hemodynamic instability
- Electrocardiographic (ECG) abnormalities These symptoms can be indicative of various cardiac injuries, such as myocardial concussion, myocardial contusion, cardiac chamber rupture, septal rupture, pericardial rupture, and valvular injuries 1. Some patients may also present with posttraumatic coronary dissection and subsequent myocardial infarction that may mimic myocardial contusion 1. It is essential to note that cardiac chamber rupture is associated with a high mortality rate and is usually caused by rapid direct impact to the anterior chest in end-diastole when the ventricles are maximally distended leading to laceration or tear in the walls of the ventricles and/or atria 1. Patients with suspected cardiac injuries who present to the emergency department after an MVA should undergo early diagnosis and lifesaving management strategies to improve the likelihood of a favorable outcome 1.
From the Research
Post MVA Symptoms
- Microvascular angina (MVA) is a condition characterized by angina with nonobstructive coronary artery disease 2
- The symptoms of MVA can be challenging to manage, and various medications have been suggested for treatment, including beta-blockers, calcium channel blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers 2
- Some studies have investigated the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and their potential effects on cardiovascular events, including MVA 3
- However, the use of NSAIDs has been associated with an increased risk of cardiovascular events, particularly with frequent or high-dose use 3
- In terms of specific symptoms, MVA can cause chest pain, shortness of breath, and fatigue, among other symptoms 2
Management of Post MVA Symptoms
- The management of post MVA symptoms typically involves a combination of lifestyle modifications and pharmacologic interventions 2
- Beta-blockers and calcium channel blockers have been shown to be effective in improving symptoms of MVA 2
- Other medications, such as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, may also be used to manage symptoms 2
- It is essential to note that the management of post MVA symptoms should be individualized and tailored to the specific needs of each patient 2
Related Conditions
- MVA has been linked to other conditions, such as cardiovascular disease and stroke 2, 3
- The use of NSAIDs has been associated with an increased risk of cardiovascular events, including stroke and myocardial infarction 3
- It is crucial to consider these potential risks and benefits when managing post MVA symptoms 2, 3