Ultrasound for critical care physicians: hypotension after a MVA

• Main Author: Schmitz E
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2014-03-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: trauma; cardiac trauma; hypotension; ultrasound; echocardiography; neurogenic stunned myocardium; stress-induced cardiomyopathy; Takatsubo's cardiomyopathy; neuorgenic shock

No abstract available. Article truncated after first page. A 25 year old woman was a restrained driver in a rollover motor vehicle accident (MVA) and suffered a C5-C6 fracture-dislocation with spinal cord injury. She was lucid and able to follow commands and could move her upper extremities but not her lower extremities. She was given approximately 6 liters of fluid but required vasopressors to maintain her blood pressure. Initial ECG revealed a normal sinus rhythm without significant ST changes (Figure 1). Upon initial evaluation her blood pressure was low. Bedside ultrasound of the left anterior second intercostal space revealed a sliding lung sign and a 4 chamber view of her heart was performed (Figure 2). Which of the following is the most likely cause of her hypotension? 1. Blunt cardiac injury; 2. Intravascular volume depletion; 3. Neurogenic stunned myocardium; 4. Pericardial tamponade; 5. Pneumothorax ...