American family physician
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American family physician · May 1997
Case ReportsCommotio cordis: clinical implications of blunt cardiac trauma.
Blunt cardiac trauma can result not only in major structural impairments but also in subtle derangements without an apparent organic defect. Cardiac dysrhythmias, including ventricular fibrillation and sudden cardiac arrest, can occur in both cardiac contusion and cardiac concussion (commotio cordis) and may be fatal. The true incidence of these nonstructural cardiac injuries is unknown. Continuous electrocardiographic monitoring, assessment of cardiac troponin I and transesophageal echocardiograms are important aids in the evaluation of cardiac contusion and concussion.
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Because anemia is a condition rather than a disease, an underlying cause must be determined when anemia is identified. Microcytic anemia is a common category of anemia. Iron deficiency anemia is the most common type of microcytic anemia and is also the most common anemia. ⋯ Low serum ferritin is the best single laboratory parameter for the diagnosis of iron deficiency. Serum iron, total iron binding capacity and hemoglobin electrophoresis, if necessary, can help differentiate the type of microcytic anemia in patients with normal or elevated levels of serum ferritin. If the evaluation identifies iron deficiency as the type of anemia, the underlying cause must be investigated.