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Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). See these publications for more information Overall, management for cardiac contusion is mostly supportive unless surgical complications develop, involving appropriate treatment of dysrhythmias and hemodynamic instability.
There is also bradycardia. Bradycardia puts patients at risk for "pause-dependent" Torsades de Pointes. Torsades in acquired long QT is much more likely in bradycardia because the QT interval following a long pause is longer still. The patient stabilized and had a good outcome. Could the dysrhythmias have been prevented?
Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. PVCs N ot generally considered abnormal ECG findings: Isolated PAC, First Degree AV Block, Sinus bradycardia at a rate of 35-45, and Nonspecific ST-T abnormalities (even if different from a previous ECG).
His rhythm on telemetry seemed to be sinus bradycardia vs junctional rhythm. In short with a very guarded likelihood for a positive outcome. Telemetry initially was interpreted as showing sinus bradycardia vs a junctional rhythm. A quick POCUS which showed significantly reduced ejection fraction and trace B lines.
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