Sunday, May 25, 2014

In a twist

In a case that merited mention in The New England Journal of Medicine, a 48-year-old Italian man sustained some major injuries in a motorcycle accident. He had broken his ribs, punctured his lungs, and ruptured spleen. But the strange thing was that his heart – along with the pulmonary artery and aorta – twisted 90° to the right. The buildup of air in the pleural cavity rather then the twisting of his body in the accident caused the dextrocardia, as it is called, which then reversed itself. Doctors Andrea Colli and Enrico Petranzan of the University of Padua write, "A total of 24 hours after pleural drainage, the patient's heart moved leftward, back into its original position, with complete anatomical and physiological recovery of the great vessels and other areas. A follow-up echocardiogram and CT scan did not show the presence of any relevant anatomical disruption of the heart, vessel tears, heart-valve dysfunction, or impairment of cardiac contractility caused by the previous rotation of the heart."

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